Cigna True Choice Medicare (PPO)

Cigna
Cigna True Choice Medicare (PPO) H7849-088 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: H7849-088

Have Medicare questions?

Talk to a licensed agent today to find a plan that fits your needs.

$0.00
Monthly Premium

Cigna True Choice Medicare (PPO) is a PPO Medicare Advantage (Medicare Part C) plan offered by Cigna
Plan ID: H7849-088

Have Medicare questions?

Talk to a licensed agent today to find a plan that fits your needs.

Cigna
Cigna True Choice Medicare (PPO) H7849-088 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: H7849-088

Have Medicare questions?

Talk to a licensed agent today to find a plan that fits your needs.

$0.00
Monthly Premium

Basic Costs and Coverage

Coverage Cost
Monthly Deductible $0
Out of Pocket Max In-Network: $4900
Out-of-Network: N/A
Initial Coverage Limit $5030
Catastrophic Coverage Limit $8,000
Primary Care Doctor Visit
$0

Out of Network
$35
Specialty Doctor Visit
$40

Out of Network
$55
Inpatient Hospital Care
$350 per day for days 1-5
$0 per day for days 6-90

Out of Network
40%
Urgent Care
$30
Copay is waived if hospital admission occurs within: 24 hours

Worldwide Urgent Coverage: $120
Emergency Room Visit
$120
Copay is waived if hospital admission occurs within: 24 hours

Worldwide Emergency Coverage: $120
Ambulance Transportation
Ambulance - Ground: $245
Ambulance - Air: 20%

Out of Network
Ambulance - Ground: $245
Ambulance - Air: 20%

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
$15
Routine Chiropractic (Supplemental): Not covered

Out of Network
50%
Diabetes Supplies, Training, Nutrition Therapy and Monitoring
If you’re managing diabetes, Cigna Healthcare makes it easier and more affordable to get monitoring and testing supplies. Your plan covers preferred brand diabetic supplies plus home delivery options. So you have less to worry about.

Diabetic Supplies: $0
Diabetic Therapeutic Shoes or Inserts: 20%

Out of Network
40%
Diabetic Therapeutic Shoes or Inserts: 40%
Durable Medical Eqipment (DME)
20%

Out of Network
40%
Diagnostic Tests, Lab and Radiology Services, and X-Rays
Lab Services: 0 - 20%
Diagnostic Radiological Services: $0 - $215
X-Ray Services: $30

Out of Network
Lab Services: 0 - 20%
Diagnostic Radiological Services: $0 - $215
X-Ray Services: $30
Home Health Care
$0

Support for Caregivers of Enrollees: Not covered


Out of Network
$0
Mental Health Inpatient Care
$350 per day for days 1-5
$0 per day for days 6-90

Out of Network
40%
Mental Health Outpatient Care
Psychiatric-Individual: $0
Psychiatric-Group: $0

Out of Network
Psychiatric-Group: $55
Outpatient Services / Surgery
In-Network:

Outpatient Hospital Services:
Copayment for Medicare Covered Outpatient Hospital Services $0.00 to $350.00
Prior Authorization Required for Outpatient Hospital Services

Outpatient Observation Services:
Copayment for Medicare Covered Observation Services - Per stay $350.00
Prior Authorization Required for Outpatient Observation Services

Ambulatory Surgical Center Services:
Copayment for Ambulatory Surgical Center Services $0.00 to $325.00
Prior Authorization Required for Ambulatory Surgical Center Services
Prior authorization required
Out-of-Network:

Outpatient Hospital and ASC Services:
Coinsurance for Medicare Covered Outpatient Hospital Services 40%
Coinsurance for Medicare Covered Ambulatory Surgical Center Services 40%
Outpatient Substance Abuse Care
$40

Out of Network
$55
Over-the-counter (OTC) Items
$80 every three months

Out of Network
Combined with in-network

Delivered via Cigna Health Today card
Podiatry Services
$40

Out of Network
$40
Skilled Nursing Facility Care
$0 per day for days 1-20
$203 per day for days 21-100

Out of Network
40%

Dental Benefits

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

Coverage Cost
Dental Care
Dental Allowance

Maximum Coverage amount for Preventive Dental: $2,500 combined preventive and comprehensive every year

Maximum Coverage Amount for Comprehensive Dental: $2,500 combined preventive and comprehensive every year

Out of Network
Dental Allowance w 50%
Maximum Coverage amount for Preventive Dental: Combined with in-network
Maximum Coverage Amount for Comprehensive Dental: Combined with in-network

Vision Benefits

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

Coverage Cost
Vision Benefits
Routine Eye Exams: $0 for one routine exam every year

Eye Exams (Medicare-covered): $0 - $40

Max Coverage Amount for Routine Eye Wear Coverage : $200 every year

Out of Network
50% for one routine exam every year
Eye Exams (Medicare-covered): 0 - 40%
Max Coverage Amount for Routine Eye Wear Coverage : Combined with in-network

Hearing Benefits

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

Coverage Cost
Hearing Benefits
$30

Fitting/Evaluation for Hearing Aids: $0 for one fitting evaluation for hearing aid every year

Hearing Aids: Hearing aids (all types): two every year
Cost Sharing: $399 - $1,800 per device

Out of Network
50%
Fitting/Evaluation for Hearing Aids: 50% for one fitting evaluation for hearing aid every year
Hearing Aids: Combined with in-network
Cost Sharing: Combined with in-network

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:
$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:

    Medicare-covered Zero Dollar Preventive Services:
    Copayment for Medicare Covered Medicare-covered Preventive Services $35.00