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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. In the initial coverage phase, you'll pay varying copays or coinsurance amounts depending on the drug tier and pharmacy used. For example, you'll have no copay for preferred generic drugs at a preferred pharmacy, while standard generic drugs have a $41 copay at a preferred pharmacy. After your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for Part D-covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit.
Additional Benefits
The MyTruAdvantage Select (HMO) plan offers a range of benefits, including inpatient hospital stays with a copay, outpatient services with varying copays, and coverage for partial hospitalization. The plan also includes ambulance services with copays, emergency and urgent care services with copays, and primary care services with copays. Additionally, the plan covers preventive services, hearing exams and hearing aids with copays, vision services, and dental services up to a yearly maximum. This plan also offers home infusion services, dialysis services with coinsurance, and durable medical equipment with coinsurance. The plan covers diagnostic and radiological services with copays, home health services with no copay, and cardiac rehabilitation services with a copay. Other benefits include skilled nursing facility stays with a copay, and over-the-counter items with a maximum benefit.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with prior authorization. For days 1-6, there is a $335 copay, and for days 7-90, there is no copay.
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, and ambulatory surgical center services with a $250 copay. Outpatient substance abuse services include individual and group sessions, both with a $25 copay, and outpatient blood services with a waived deductible.
Partial Hospitalization See details
Partial Hospitalization is covered under the MyTruAdvantage Select (HMO) plan, with a $55 copay. Prior authorization is required 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, and air ambulance services have a $325 copay, but there is no coinsurance. 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 by the MyTruAdvantage Select (HMO) plan. Emergency Services have a $90 copay, and Urgently Needed Services have a $30 copay. Worldwide Emergency Coverage has a $90 copay, Worldwide Urgent Coverage has a $35 copay, and Worldwide Emergency Transportation has a copay between $260 and $325.
Primary Care See details
MyTruAdvantage Select (HMO) covers Primary Care Physician Services, Chiropractic Services with a $20 copay, 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, Additional Telehealth Benefits with a copay between $0 and $25, and Opioid Treatment Program Services. However, Routine Chiropractic Care and Podiatry Services are not covered.
Preventive Services See details
The MyTruAdvantage Select (HMO) plan covers preventive services, including Medicare-covered services, annual physical exams, kidney disease education services, and other preventive services. Additional services such as health education, in-home safety assessments, and others are not covered. The plan also covers a fitness benefit.
Hearing Services See details
Hearing exams, including routine hearing exams and fitting/evaluation for hearing aids, are covered. Routine hearing exams are limited to 1 per year, and fitting/evaluation for hearing aids is limited to 3 with the purchase of a hearing aid. Prescription hearing aids are covered with a copay between $399 and $899, but inner ear, outer ear, and over-the-ear hearing aids are not covered. OTC hearing aids are not covered.
Vision Services See details
Vision services are covered, including routine eye exams with a maximum benefit of $250 every year, contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and 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. This plan covers oral exams (2 per year), dental x-rays (1 per year), other diagnostic dental services, prophylaxis (cleaning) (2 per year), fluoride treatment (2 per year), restorative services (1 per 5 years), adjunctive general services, endodontics, periodontics, prosthodontics, removable (1 per 5 years), implant services (1 per tooth per 5 year period), prosthodontics, fixed (1 per 5 year period), and oral and maxillofacial surgery (1 extraction per tooth per lifetime). However, maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the MyTruAdvantage Select (HMO) plan, including Medicare Part B Insulin Drugs with a $35 copay. 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. This benefit requires prior authorization and has a coinsurance of 20%.
Medical Equipment See details
The MyTruAdvantage Select (HMO) plan covers Durable Medical Equipment (DME) with a 20% coinsurance, and Prosthetics/Medical Supplies with a 20% coinsurance. Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered, and Diabetic Therapeutic Shoes/Inserts are covered with a 15% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services include coverage for all diagnostic services with a $50 copay, although Lab Services are not covered. Diagnostic Radiological Services have a maximum copay of $205, Therapeutic Radiological Services have a $40 copay, and Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the MyTruAdvantage Select (HMO) plan, with no copay and no coinsurance. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are covered, but the plan does not cover Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. There is a copay for these services; however, the amount is not specified in the provided information.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays are not covered.
Other Services See details
The MyTruAdvantage Select (HMO) plan's "Other Services" benefit covers over-the-counter items with a maximum benefit of $100 every three months, including nicotine replacement therapy and Naloxone, but does not cover all drugs on the CMS OTC list. Acupuncture, meal benefits, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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