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MyTruAdvantage Select (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MyTruAdvantage Select (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on MyTruAdvantage Select (HMO) in 2025, please refer to our full plan details page.
MyTruAdvantage Select (HMO) is a HMO plan offered by SIHO Holding, Inc. available for enrollment in 2025 to people living in Indiana (Partial). This plan received an overall rating of 4 out of 5 stars in 2025.
It's important to know that MyTruAdvantage Select (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about MyTruAdvantage Select (HMO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For MyTruAdvantage Select (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3500.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
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Drug Coverage
The MyTruAdvantage Select (HMO) plan has a $0 deductible for prescription drugs. During the initial coverage phase, you will pay different copays or coinsurance amounts depending on the drug tier and pharmacy you use. For example, preferred generic drugs have no copay at a preferred pharmacy, while standard generic drugs have a $41 copay. After your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for covered Part D drugs. If you qualify for the low-income subsidy, you will pay $0 for your Part D drugs.
Additional Benefits
The MyTruAdvantage Select (HMO) plan offers a range of benefits with varying cost-sharing. Inpatient hospital stays have a copay, while outpatient services have copays ranging from $25 to $250. Emergency services and primary care visits have copays, with no copays for preventive services and routine eye exams. The plan also covers hearing aids with copays, dental services up to a yearly maximum, and home health services with no copay. Other covered services include ambulance, partial hospitalization, and skilled nursing facilities with different copays, as well as diagnostic and radiological services with copays. Additionally, the plan provides coverage for medical equipment, dialysis, and over-the-counter items, while some services like podiatry and health education are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered, with a copay of $335 for days 1-6 and no copay for days 7-90. Additional days for Inpatient Hospital-Acute are covered, but non-Medicare-covered stays and upgrades for Inpatient Hospital-Acute are not covered, and additional days and non-Medicare-covered stays for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services include coverage for all outpatient hospital services with a copay of $40-$250, observation services with a $250 copay, ambulatory surgical center (ASC) services with a $250 copay, outpatient substance abuse services with a $25 copay for both individual and group sessions, and outpatient blood services.
Partial Hospitalization See details
Partial Hospitalization is covered by the MyTruAdvantage Select (HMO) plan, but requires prior authorization. You will have a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the MyTruAdvantage Select (HMO) plan. Ground ambulance services have a $260 copay, while air ambulance services have a $325 copay, and there is no coinsurance for either. Transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered under the MyTruAdvantage Select (HMO) plan. Emergency Services have a $90 copay, Urgently Needed Services have a $30 copay, and Worldwide Emergency Services have copays ranging from $35 to $325 depending on the service.
Primary Care See details
MyTruAdvantage Select (HMO) covers primary care physician services with no copay, chiropractic services with a $20 copay for routine care, occupational therapy services with a $35 copay, physician specialist services with a $25 copay, and mental health specialty services with a $25 copay for individual and group sessions. The plan also covers physical therapy and speech-language pathology services with a $35 copay, along with additional telehealth benefits with a copay between $0 and $25, and opioid treatment program services. Podiatry services are not covered.
Preventive Services See details
Preventive Services, including annual physical exams, are covered under the MyTruAdvantage Select (HMO) plan. Other preventive services, such as glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a Welcome Visit, are also covered. However, health education, in-home safety assessments, personal emergency response systems, and several other services are not covered.
Hearing Services See details
Hearing exams, routine hearing exams, and fitting/evaluation for hearing aids are covered under this plan. This plan covers routine hearing exams once per year, and fitting/evaluation for hearing aids three times with the purchase of a hearing aid. Prescription hearing aids (all types) are covered with a copay between $399 and $899, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered, and OTC hearing aids are not covered.
Vision Services See details
Vision services are covered, including routine eye exams and eyewear. Routine eye exams are covered with no copay, and there is a maximum plan benefit coverage of $250 every year. Eyewear includes contact lenses, eyeglasses (lenses and frames), eyeglass lenses, and eyeglass frames. Upgrades are not covered.
Dental Services See details
The MyTruAdvantage Select (HMO) plan covers dental services with a maximum benefit of $2560 per year. Oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), and fluoride treatments are covered, with limits on visits. Restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), implant services, and oral and maxillofacial surgery are also covered, but maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered under the MyTruAdvantage Select (HMO) plan, but require prior authorization. The coinsurance for dialysis services is 20%.
Medical Equipment See details
Medical Equipment benefits include Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetic Devices and Medical Supplies with a 20% coinsurance, though Durable Medical Equipment for use outside the home is not covered. Diabetic Therapeutic Shoes/Inserts are covered with a 15% coinsurance, but Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including diagnostic procedures and tests with a $50 copay. Radiological services are also covered with a copay of at most $205 for diagnostic services, $40 for therapeutic services, and $25 for outpatient X-rays. Lab services are not covered.
Home Health Services See details
Home Health Services are covered by the MyTruAdvantage Select (HMO) plan with no copay or coinsurance. However, Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered by the MyTruAdvantage Select (HMO) plan, but none of the specific services are covered, including Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, and SET for PAD Services. There is a copay for some Cardiac and Pulmonary Rehabilitation Services, but the exact cost is not specified.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered under the MyTruAdvantage Select (HMO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214 per day. Additional days beyond Medicare-covered and non-Medicare-covered stays for SNF are not covered.
Other Services See details
The MyTruAdvantage Select (HMO) plan covers Over-the-Counter (OTC) Items with a maximum benefit of $100 every three months, and also covers Nicotine Replacement Therapy (NRT) and Naloxone. Acupuncture, meal benefits, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, and several other services are not covered.
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