HealthSpring True Choice (PPO)

3 out of 5 stars
$0.00
Monthly Premium

HealthSpring True Choice (PPO) is a PPO plan offered by Cigna

Plan ID: H7849-088

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.


Medicare beneficiaries may find it helpful to review available Medicare Advantage plans in their area. Medicare Advantage plans are designed to combine the coverage offered from Original Medicare (Medicare Part A and Part B) while also offering additional benefits.

Many Medicare Advantage plans may cover prescription drug coverage as well as additional benefits such as Dental, Vision and Hearing.

Learn more about Medicare Advantage plans such as HealthSpring True Choice (PPO) - H7849-088 by Cigna as well as other Medicare Advantage plans available in your area.

$0.00
Monthly Premium

Kentucky Counties Served

Basic Costs and Coverage

Coverage Cost
Monthly Deductible $200
Out of Pocket Max In-Network: $9250
Out-of-Network: 13900
Initial Coverage Limit $0
Catastrophic Coverage Limit $2100
Primary Care Doctor Visit

Out-of-Network:

Doctor Office Visit Services:
Copayment for Medicare Covered Primary Care Office Visit $35
Specialty Doctor Visit
In-Network:

Doctor Specialty Visit:
Copayment for Physician Specialist Office Visit $50
Prior Authorization Required for Doctor Specialty Visit
Inpatient Hospital Care

Out-of-Network:

Acute Hospital Services:
Coinsurance for Acute Hospital Services per Stay 50%
In some instances, a readmission policy may apply in which the benefit will continue from original admission.
Urgent Care

Urgent Care:
Copayment for Urgent Care $40
Copayment for Medicare Covered Urgent Care waived if you are admitted to hospital within 24 hours

Worldwide Coverage:
Copayment for Worldwide Urgent Coverage $115
Maximum Plan Benefit of $50,000
Emergency Room Visit

Emergency Care:
Copayment for Emergency Care $115
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 $115
Copayment for Worldwide Emergency Transportation $115
Maximum Plan Benefit of $50,000
Ambulance Transportation

Out-of-Network:

Ambulance Services:
Copayment for Medicare Covered Ambulance Services - Ground $245
Coinsurance for Medicare Covered Ambulance Services - Air $20%

Health Care Services and Medical Supplies

HealthSpring True Choice (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:

Chiropractic Services:
Copayment for Medicare-covered Chiropractic Services $15
Prior Authorization Required for Chiropractic Services

Out-of-Network:

Chiropractic Services:
Coinsurance for Medicare Covered Chiropractic Services 50%
Diabetes Supplies, Training, Nutrition Therapy and Monitoring
In-Network:

Diabetic Supplies and Services:
Copayment for Medicare-covered Diabetic Supplies $0
Coinsurance for Medicare-covered Diabetic Therapeutic Shoes or Inserts 20%
Durable Medical Equipment (DME)
In-Network:

Durable Medical Equipment:
Coinsurance for Medicare-covered Durable Medical Equipment 20%
Prior Authorization Required for Durable Medical Equipment
Diagnostic Tests, Lab and Radiology Services, and X-Rays

Out-of-Network:

Diagnostic Procedures/Tests Services:
Coinsurance for Medicare Covered Diagnostic Procedures/Tests
50%
Coinsurance for Medicare Covered Lab Services
50%
Coinsurance for Medicare Covered Diagnostic Radiological Services 50%
Coinsurance for Medicare Covered Therapeutic Radiological Services 50%
Coinsurance for Medicare Covered Outpatient X-Ray Services 50%
Minimum for EKG. Maximum for all other diagnostic procedures and tests.
Home Health Care
In-Network:

Home Health Services:
Copayment for Medicare-covered Home Health Services $0
Prior Authorization Required for Home Health Services
Mental Health Inpatient Care

Out-of-Network:

Psychiatric Hospital Services:
Coinsurance for Psychiatric Hospital per Stay 50%
In some instances, a readmission policy may apply in which the benefit will continue from original admission.
Mental Health Outpatient Care

Out-of-Network:

Mental Health Services:
Copayment for Medicare Covered Individual Sessions $55
Copayment for Medicare Covered Group Sessions $55
Outpatient Services / Surgery
In-Network:

Outpatient Hospital Services:
Copayment for Medicare Covered Outpatient Hospital Services $0 to $385
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 $385
Prior Authorization Required for Outpatient Observation Services

Ambulatory Surgical Center Services:
Copayment for Ambulatory Surgical Center Services $0 to $360
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.
Outpatient Substance Abuse Care

Out-of-Network:

Outpatient Substance Abuse Services:
Copayment for Medicare Covered Individual Sessions $60
Copayment for Medicare Covered Group Sessions $60
In-Network:

Outpatient Substance Abuse Services:
Copayment for Medicare-covered Individual Sessions $50
Copayment for Medicare-covered Group Sessions $50
Prior Authorization Required for Outpatient Substance Abuse Services
Over-the-counter (OTC) Items
Podiatry Services

Out-of-Network:

Podiatry Services:
Coinsurance for Medicare Covered Podiatry Services 50%
In-Network:

Podiatry Services:
Copayment for Medicare-Covered Podiatry Services $45
Skilled Nursing Facility Care

Out-of-Network:

Skilled Nursing Facility Services:
Coinsurance for Skilled Nursing Facility per Stay 50%
In some instances, a readmission policy may apply in which the benefit will continue from original admission.

Dental Benefits

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

Coverage Cost
Dental Care

Out-of-Network:

Preventive Dental Services:
Copayment for Medicare Covered Preventive Dental $60

Vision Benefits

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

Coverage Cost
Vision Benefits

Out-of-Network:

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

Hearing Benefits

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

Coverage Cost
Hearing Benefits
In-Network:

Hearing Exams:
Copayment for Medicare Covered Benefits $25
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

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

Prescription Drug Costs and Coverage

The HealthSpring True Choice (PPO) plan offers the following prescription drug coverage, with an annual drug deductible of $200 (excludes Tiers 1 and 2) per year.

Coverage Cost
Coverage & Cost
Annual Drug Deductible $200 (excludes Tiers 1 and 2)
Preferred Generic
  • Preferred cost-share mail order $0.00
  • Standard retail $10.00
  • Standard mail order $10.00
  • Preferred cost-share retail $0.00
Generic
  • Preferred cost-share mail order $4.00
  • Standard retail $20.00
  • Standard mail order $20.00
  • Preferred cost-share retail $4.00
Annual Drug Deductible $200 (excludes Tiers 1 and 2)
Preferred Generic
  • Preferred cost-share mail order $0.00
  • Standard retail $20.00
  • Standard mail order $20.00
  • Preferred cost-share retail $0.00
Generic
  • Preferred cost-share mail order $8.00
  • Standard retail $40.00
  • Standard mail order $40.00
  • Preferred cost-share retail $8.00
Annual Drug Deductible $200 (excludes Tiers 1 and 2)
Preferred Generic
  • Preferred cost-share mail order $0.00
  • Standard retail $30.00
  • Standard mail order $30.00
  • Preferred cost-share retail $0.00
Generic
  • Preferred cost-share mail order $0.00
  • Standard retail $60.00
  • Standard mail order $60.00
  • Preferred cost-share retail $12.00
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