Cigna True Choice Medicare (PPO)

Cigna
Cigna True Choice Medicare (PPO) H7849-029 Plan Details
3 out of 5 stars

Cigna True Choice Medicare (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Cigna
Plan ID: H7849-029

HelpAdvisor Editorial Team analysis of data from the 2025 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.

$0.00
Monthly Premium

Cigna True Choice Medicare (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Cigna
Plan ID: H7849-029

HelpAdvisor Editorial Team analysis of data from the 2025 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.

Cigna
Cigna True Choice Medicare (PPO) H7849-029 Plan Details
3 out of 5 stars

Cigna True Choice Medicare (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Cigna
Plan ID: H7849-029

HelpAdvisor Editorial Team analysis of data from the 2025 MA Landscape Source Files and carrier-provided plan data supplied by SunFire, Inc., a private company that creates software solutions for agents and brokers to compare Medicare plans. For more information, visit www.sunfireinc.com.

$0.00
Monthly Premium

Basic Costs and Coverage

Coverage Cost
Monthly Deductible $0
Out of Pocket Max In-Network: $4300
Out-of-Network: N/A
Initial Coverage Limit $2000
Catastrophic Coverage Limit $2,000
Primary Care Doctor Visit
In Network
In-Network:

Doctor Office Visit:
Copayment for Primary Care Office Visit $0


Out of Network

Out-of-Network:

Doctor Office Visit Services:
Copayment for Medicare Covered Primary Care Office Visit $25
Specialty Doctor Visit
In Network
In-Network:

Doctor Specialty Visit:
Copayment for Physician Specialist Office Visit $30
Prior Authorization Required for Doctor Specialty Visit


Out of Network

Out-of-Network:

Doctor Specialty Visit Services:
Copayment for Medicare Covered Physician Specialist Office Visit $65
Prior authorization required
Inpatient Hospital Care
In Network
In-Network:

Acute Hospital Services:
$305 per day for days 1 to 5
$0 per day for days 6 to 90
Prior Authorization Required for Acute Hospital Services
In some instances, a readmission policy may apply in which the benefit will continue from original admission.


Out of Network

Out-of-Network:

Acute Hospital Services:
Coinsurance for Acute Hospital Services per Stay 40%
In some instances, a readmission policy may apply in which the benefit will continue from original admission.
Prior authorization required
Urgent Care
Copayment for Urgent Care $30
Copayment for Medicare Covered Urgent Care waived if you are admitted to hospital within 2 hours

Worldwide Coverage:
Copayment for Worldwide Urgent Coverage $125
Maximum Plan Benefit of $50,000
Emergency Room Visit
Copayment for Emergency Care $125
Copayment for Medicare Covered Emergency Care waived if you are admitted to the hospital with in 24 hours

Worldwide Coverage:
Copayment for Worldwide Emergency Coverage $125
Copayment for Worldwide Emergency Transportation $125
Maximum Plan Benefit of $50,000
Ambulance Transportation
In Network
In-Network:

Ground Ambulance:
Copayment for Ground Ambulance Services $160

Air Ambulance:
Coinsurance for Air Ambulance Services 20%
Prior Authorization Required for Air Ambulance


Out of Network

Out-of-Network:

Ambulance Services:
Copayment for Medicare Covered Ambulance Services - Ground $160
Coinsurance for Medicare Covered Ambulance Services - Ground 20%
Copayment for Medicare Covered Ambulance Services - Air $160
Coinsurance for Medicare Covered Ambulance Services - Air 20%
Prior authorization required

Health Care Services and Medical Supplies

Cigna True Choice Medicare (PPO) covers additional benefits and services, some of which may not be covered by Original Medicare (Medicare Part A and Part B).

Coverage Cost
Chiropractic Services
In Network
In-Network:
Copayment for Medicare-covered Chiropractic Services $15
Prior Authorization Required for Chiropractic Services


Out of Network

Out-of-Network:

Medicare Covered Chiropractic Services:
Coinsurance for Medicare Covered Chiropractic Services 50%
Prior authorization required
Diabetes Supplies, Training, Nutrition Therapy and Monitoring
In Network
In-Network:
Copayment for Medicare-covered Diabetic Supplies $0
Coinsurance for Medicare-covered Diabetic Therapeutic Shoes or Inserts 15%


Out of Network

Out-of-Network:

Medicare Covered Diabetic Supplies and Services:
Coinsurance for Medicare Covered Diabetic Supplies 40%
Coinsurance for Medicare Covered Diabetic Therapeutic Shoes or Inserts 40%
Durable Medical Eqipment (DME)
In Network
In-Network:
Coinsurance for Medicare-covered Durable Medical Equipment 15%
Prior Authorization Required for Durable Medical Equipment


Out of Network

Out-of-Network:

Medicare Covered Durable Medical Equipment Services:
Coinsurance for Medicare Covered Durable Medical Equipment 40%
Prior authorization required
Diagnostic Tests, Lab and Radiology Services, and X-Rays
In Network
In-Network:

Outpatient Diag Procs/Tests/Lab Services:
Copayment for Medicare-covered Diagnostic Procedures/Tests $0 to $25
Copayment for Medicare-covered Lab Services $0 to $50
Prior Authorization Required for Outpatient Diag Procs/Tests/Lab Services
Minimum for EKG. Maximum for all other diagnostic procedures and tests.

Outpatient Diag/Therapeutic Rad Services:
Copayment for Medicare-covered Diagnostic Radiological Services $0 to $250
Coinsurance for Medicare-covered Therapeutic Radiological Services 20%
Copayment for Medicare-covered X-Ray Services $0 to $15
If multiple test types (e.g. CT and PET) are performed on the same day, multiple copayments will apply. If multiple tests of the same type (e.g. CT scan of the head and CT scan of the chest) are performed on the same day, one copayment will apply.


Out of Network

Out-of-Network:

Medicare Covered Diagnostic Procedures/Tests Services:
Coinsurance for Medicare Covered Diagnostic Procedures/Tests
40%
Coinsurance for Medicare Covered Lab Services
40%
Coinsurance for Medicare Covered Diagnostic Radiological Services 40%
Coinsurance for Medicare Covered Therapeutic Radiological Services 40%
Coinsurance for Medicare Covered Outpatient X-Ray Services 40%
Minimum for EKG. Maximum for all other diagnostic procedures and tests.
Prior authorization required
Home Health Care
In Network
In-Network:
Copayment for Medicare-covered Home Health Services $0
Prior Authorization Required for Home Health Services


Out of Network

Out-of-Network:

Medicare Covered Home Health Services:
Coinsurance for Medicare Covered Home Health 40%
Prior authorization required
Mental Health Inpatient Care
In Network
In-Network:

Psychiatric Hospital Services:
$305 per day for days 1 to 5
$0 per day for days 6 to 90
Prior Authorization Required for Psychiatric Hospital Services
In some instances, a readmission policy may apply in which the benefit will continue from original admission.


Out of Network

Out-of-Network:

Psychiatric Hospital Services:
Coinsurance for Psychiatric Hospital per Stay 40%
In some instances, a readmission policy may apply in which the benefit will continue from original admission.
Prior authorization required
Mental Health Outpatient Care
In Network
In-Network:
Copayment for Medicare-covered Individual Sessions $0
Copayment for Medicare-covered Group Sessions $0


Out of Network

Out-of-Network:

Medicare Covered Mental Health Services:
Coinsurance for Medicare Covered Individual Sessions 50%
Coinsurance for Medicare Covered Group Sessions 50%
Outpatient Services / Surgery
In Network
In-Network:

Outpatient Hospital Services:
Copayment for Medicare Covered Outpatient Hospital Services $0 to $305
Prior Authorization Required for Outpatient Hospital Services
Minimum for any surgical procedures (e.g. polyp removal) during a colorectal screening. Maximum for all other outpatient services not provided in an Ambulatory Surgical Center.

Outpatient Observation Services:
Copayment for Medicare Covered Observation Services - Per stay $305
Prior Authorization Required for Outpatient Observation Services

Ambulatory Surgical Center Services:
Copayment for Ambulatory Surgical Center Services $0 to $275
Prior Authorization Required for Ambulatory Surgical Center Services
Minimum for any surgical procedures (e.g. polyp removal) during a colorectal screening. Maximum for all other Ambulatory Surgical Center (ASC) services.


Out of Network

Out-of-Network:

Medicare Covered Outpatient Hospital Services:
Coinsurance for Medicare Covered Outpatient Hospital Services 40%
Coinsurance for Medicare Covered Ambulatory Surgical Center Services 40%
Minimum for any surgical procedures (e.g. polyp removal) during a colorectal screening. Maximum for all other outpatient services not provided in an Ambulatory Surgical Center.
Prior authorization required
Outpatient Substance Abuse Care
In Network
In-Network:
Copayment for Medicare-covered Individual Sessions $30
Copayment for Medicare-covered Group Sessions $30
Prior Authorization Required for Outpatient Substance Abuse Services


Out of Network

Out-of-Network:

Medicare Covered Outpatient Substance Abuse Services:
Copayment for Medicare Covered Individual Sessions $65
Copayment for Medicare Covered Group Sessions $65
Prior authorization required
Over-the-counter (OTC) Items
In Network
In-Network:

Over-The-Counter (OTC) Items:
Copayment for Over-The-Counter (OTC) Items $0
  • Maximum plan benefit of $60.00 every three months for Over-The-Counter (OTC) Items
Maximum Plan Benefit of $60 every three months
Catalog orders limited to one per member per month. Exceptions may apply.


Out of Network

Out-of-Network:

Non-Medicare Covered Over-The-Counter (OTC) Items Services:
Copayment for Non-Medicare Covered Over-The-Counter (OTC) Items $0
  • Maximum 60 visits every three months
Maximum Plan Benefit of $60
Podiatry Services
In Network
In-Network:

Medicare Covered Podiatry Services:
Copayment for Medicare-Covered Podiatry Services $30


Out of Network

Out-of-Network:

Medicare Covered Podiatry Services:
Coinsurance for Medicare Covered Podiatry Services 50%
Skilled Nursing Facility Care
In Network
In-Network:

Skilled Nursing Facility Services:
$0 per day for days 1 to 20
$214 per day for days 21 to 100
Prior Authorization Required for Skilled Nursing Facility Services
In some instances, a readmission policy may apply in which the benefit will continue from original admission.


Out of Network

Out-of-Network:

Skilled Nursing Facility Services:
$200 per day for days 1 to 30
$0 per day for days 31 to 100
In some instances, a readmission policy may apply in which the benefit will continue from original admission.
Prior authorization required

Dental Benefits

The following dental services are covered from in-network providers.

Coverage Cost
Dental Care
In Network
In-Network:

Preventive Dental:
Copayment for Office Visit $30
Prior Authorization Required for Preventive Dental

Comprehensive Dental:
Copayment for Non-routine Services $0
Copayment for Diagnostic Services $0
Copayment for Restorative Services $0
Copayment for Endodontics $0
Copayment for Periodontics $0
Copayment for Extractions $0
Maximum Plan Benefit of $1,100 every year


Out of Network

Out-of-Network:

Medicare Covered Preventive Dental Services:
Copayment for Medicare Covered Preventive Dental $65
Prior authorization required

Vision Benefits

The following vision services are covered from in-network providers.

Coverage Cost
Vision Benefits
In Network
In-Network:

Eye Exams:
Copayment for Medicare Covered Benefits $0 to $30
Copayment for Routine Eye Exams $0
  • Maximum 1 Routine Eye Exam every year

Eyewear:
Copayment for Medicare-Covered Benefits $0
Copayment for Contact Lenses $0
Copayment for Eyeglasses (lenses and frames) $0
  • Maximum 1 Pair every year
Copayment for Eyeglass Lenses $0
  • Maximum 1 Pair every year
Copayment for Eyeglass Frames $0
  • Maximum 1 Pair every year
Copayment for Upgrades $0
Maximum Plan Benefit of $100 every year
Corrective lenses, frames and contacts are covered once per year. The plan will not cover both corrective lenses/frames and contacts in the same benefit year.


Out of Network

Out-of-Network:

Medicare Covered Eye Exams Services:
Coinsurance for Medicare Covered Eye Exams 50%
Coinsurance for Medicare Covered Eyewear 40%

Hearing Benefits

The following hearing services are covered from in-network providers.

Coverage Cost
Hearing Benefits
In Network
In-Network:

Hearing Exams:
Copayment for Medicare Covered Benefits $30
Copayment for Routine Hearing Exams $0
  • Maximum 1 visit every year
Copayment for Fitting/Evaluation for Hearing Aid $0
  • Maximum 1 visit every year

Hearing Aids:
Copayment for Hearing Aids $399 to $1800
  • Maximum 2 Hearing Aids every year


Out of Network

Out-of-Network:

Medicare Covered Hearing Exams Services:
Coinsurance for Medicare Covered Hearing Exams 50%

Preventive Services and Health/Wellness Education Programs

The following services are covered from in-network providers.

Coverage Cost
Preventive Services and Health/Wellness Education Programs
In Network
In-Network:
$0.00 copay for Medicare Covered Preventive Services:

Abdominal aortic aneurysm screening
Alcohol misuse screenings & counseling
Bone mass measurements (bone density)
Cardiovascular disease screenings
Cardiovascular disease (behavioral therapy)
Cervical & vaginal cancer screening
Colorectal cancer screenings
Depression screenings
Diabetes screenings
Diabetes self-management training
Glaucoma tests
Hepatitis B (HBV) infection screening
Hepatitis C screening test
HIV screening
Lung cancer screening
Mammograms (screening)
Nutrition therapy services
Obesity screenings & counseling
One-time Welcome to Medicare preventive visit
Prostate cancer screenings(PSA)
Sexually transmitted infections screening & counseling
Shots:
  • COVID-19 shots
  • Flu shots
  • Hepatitis B shots
  • Pneumococcal shots
  • Tobacco use cessation
    Yearly "Wellness" visit



    Out of Network

    Out-of-Network:

    Medicare Covered Medicare-covered Preventive Services:
    Copayment for Medicare Covered Medicare-covered Preventive Services $25