What is Cigna True Choice Plus Medicare?
Cigna True Choice Plus Medicare is a Medicare Advantage Prescription Drug (MAPD) plan that uses a Preferred Provider Organization (PPO) network. It is designed for seniors and eligible individuals who want the flexibility of seeing both innetwork and outofnetwork providers while still receiving the added coverage and costsaving features of a Medicare Advantage plan.
Key characteristics:
- Combines Medicare PartA (hospital) and PartB (medical) benefits.
- Includes Medicare PartD prescription drug coverage.
- Offers a PPO network, so you can see any doctor that accepts Medicare, though youll pay less when you stay innetwork.
- Provides additional benefits not covered by Original Medicare, such as vision, hearing, dental, and fitness programs.
How the PPO Structure Works
Unlike Health Maintenance Organization (HMO) plans that require a primary care doctor and referrals, the PPO model lets you:
- Visit specialists without a referral.
- Choose providers outside the Cigna network, paying a higher share of the cost.
- Take advantage of lower copays and coinsurance when you stay within the network.
This flexibility is especially valuable for beneficiaries who travel frequently, have longstanding relationships with outofnetwork doctors, or need specialized care that may not be widely available in a local network.
Core Benefits
Medical Coverage
- Inpatient hospital stays
- Skilled nursing facility care
- Home health services
- Emergency and urgent care
- Outpatient surgery
- Preventive services (screenings, vaccines, wellness visits)
Prescription Drug Coverage (PartD)
Formulary tiers, generic preferred drugs at the lowest cost, and a $0 copay for many preventive medications. Most plans include a $0$5 copay for common prescriptions like statins and antihypertensives.
Additional Benefits
- Dental: twiceyear cleaning, two routine exams, and limited restorative work.
- Vision: annual eye exam, $150 allowance for glasses or contacts.
- Hearing: annual hearing exam and $100 hearing aid allowance.
- Fitness: free membership to select gyms (e.g., SilverSneakers).
- Telehealth: virtual visits with primary care and specialists.
Cost Overview
Costs vary by county, but the major components are:
| Cost Component | Typical Amount | Notes |
|---|---|---|
| Monthly Premium | $0 $45 | Many plans offer $0 premium if you also have a $0 PartB premium. |
| Annual Deductible (InNetwork) | $0 $250 | Usually $0 for most services; prescription drug deductible may apply. |
| Coinsurance (InNetwork Office Visit) | $0 $25 | Often $0 for preventive visits. |
| OutofNetwork Copay/Coinsurance | 20%40% after deductible | Higher than innetwork; deductible applies first. |
| Prescription Drug Copay | $0 $15 (generic), $15 $50 (brand) | Depends on formulary tier. |
Remember: Actual outofpocket costs depend on your utilization, the providers you choose, and whether you use innetwork vs. outofnetwork services.
Eligibility and Enrollment
- Must be enrolled in Original Medicare PartA and PartB.
- Generally, you must be 65 or older, but some younger individuals with certain disabilities qualify.
- Enrollment periods:
- Initial Enrollment Period (IEP) 7 months surrounding your 65th birthday.
- Annual Election Period (AEP) Oct15 to Dec7 each year.
- Special Enrollment Periods after moving, losing other coverage, or other qualifying events.
How It Compares to Other Medicare Options
True Choice Plus PPO vs. Cigna HMO Plans
- Flexibility: PPO lets you see any Medicareaccepting doctor; HMO requires referrals and primarycare gatekeeping.
- Cost: PPOs often have higher outofnetwork costs; HMO plans generally have lower overall premiums and copays.
- Travel: PPO is better for travelers because outofnetwork coverage is available.
True Choice Plus PPO vs. Original Medicare + Medigap
- AllinOne: The PPO bundles hospital, medical, and drug coverage plus extra benefits, while Original Medicare requires separate PartD and possibly a Medigap policy.
- Network Savings: PPOs negotiated rates often result in lower outofpocket spending than Original Medicare alone.
- Flexibility: Original Medicare with Medigap allows unlimited provider choice with no network, but may result in higher premiums.
Things to Consider Before Enrolling
- Provider Network: Check whether your preferred doctors and hospitals are in the Cigna PPO network.
- Travel Needs: If you spend a lot of time out of state, a PPO may give you better protection.
- Prescription Drugs: Review the formulary to make sure the medications you regularly take are covered at a low tier.
- Cost Predictability: Estimate your annual outofpocket costs using Cignas costcalculator tools.
- Additional Benefits: Evaluate the value of dental, vision, hearing, and fitness perks for your lifestyle.
How to Get Started
- Visit Cignas official True Choice Plus page to review plan options in your county.
- Enter your ZIP code to see specific premium and cost details.
- Compare the list of innetwork doctors and hospitals.
- Use the online enrollment tool or call the tollfree number(800)5551234 to speak with a licensed agent.
- Enroll during the Annual Election Period or a qualifying Special Enrollment Period.
Frequently Asked Questions
Can I keep my current doctor?
If your doctor participates in the Cigna PPO network, you can continue seeing them without extra cost. If not, you can still see them as an outofnetwork provider, but youll pay a higher coinsurance after the deductible.
What happens if I travel abroad?
Most Cigna Medicare PPO plans do not cover routine care outside the U.S. However, emergency care abroad may be covered in limited circumstances. Consider a supplemental travel insurance policy for comprehensive overseas coverage.
Do I need to enroll in a separate PartD plan?
No. The Plus in True Choice Plus indicates that prescription drug coverage is already included.
Are there any outofpocket maximums?
Yes. The plan includes an annual outofpocket limit (typically $6,800 for innetwork services). Once you reach this limit, the plan pays 100% of covered innetwork costs for the rest of the year.
