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MyTruAdvantage Select Plus (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MyTruAdvantage Select Plus (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on MyTruAdvantage Select Plus (HMO) in 2025, please refer to our full plan details page.
MyTruAdvantage Select Plus (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 Plus (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 Plus (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 Plus (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 a $200.00 drug deductible. You will need to pay this amount towards covered prescriptions before your insurance coverage for prescription medications kicks in.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $3700.00 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 Plus (HMO) plan has a $200 deductible for prescription drugs. After meeting the deductible, you will pay a copay or coinsurance depending on the drug tier and the pharmacy you use. For example, preferred generic drugs have a $5 copay at preferred pharmacies, while standard generic drugs have a $41 copay. The plan covers specialty tier drugs with no copay. Once your total drug costs reach $2000, you enter the catastrophic coverage phase and pay nothing for covered drugs.
Additional Benefits
The MyTruAdvantage Select Plus (HMO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay of $335 for the first six days, then no copay. Outpatient services and emergency services have copays that vary depending on the service. The plan also covers primary care, preventive services, hearing, vision, dental, and home health services. Hearing services offer coverage for routine exams and hearing aids with copays, vision services cover routine eye exams and eyewear up to a certain amount, and dental services have a maximum annual benefit. Additionally, the plan offers coverage for medical equipment and home infusion services with coinsurance costs, and skilled nursing facilities with copays.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered. For Inpatient Hospital-Acute, you will pay a $335 copay for days 1-6, and no copay for days 7-90. For Inpatient Hospital Psychiatric, you will pay a $335 copay for days 1-6, and no copay for days 7-90. Non-Medicare-covered stay and upgrades for Inpatient Hospital-Acute, and Additional Days and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient Services are covered by the MyTruAdvantage Select Plus (HMO) plan, including outpatient hospital services with a copay of $40-$300, observation services with a $250 copay, and ambulatory surgical center services with a $250 copay. Outpatient substance abuse services are also covered, with individual and group sessions each having a copay of $25.
Partial Hospitalization See details
Partial Hospitalization is covered by the MyTruAdvantage Select Plus (HMO) plan, with a $55 copay. Prior authorization is required.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with prior authorization required for all ambulance services. Ground ambulance services have a $265 copay, and air ambulance services have a $325 copay; there is no coinsurance for any ambulance services. 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 Plus (HMO) plan. Emergency Services have a $140 copay, Urgently Needed Services have a $30 copay, Worldwide Emergency Coverage has a $90 copay, Worldwide Urgent Coverage has a $25 copay, and Worldwide Emergency Transportation has a $260-$325 copay, with no coinsurance for any service.
Primary Care See details
Primary Care Physician Services, Chiropractic Services, Occupational Therapy Services, Physician Specialist Services, Mental Health Specialty Services, Other Health Care Professional, Psychiatric Services, Physical Therapy and Speech-Language Pathology Services, Additional Telehealth Benefits, and Opioid Treatment Program Services are covered. Chiropractic services have a $20 copay, physician specialist services have a $30 copay, occupational therapy services have a $35 copay, physical therapy and speech-language pathology services have a $35 copay, and additional telehealth benefits have a copay between $0 and $25. Routine chiropractic care is not covered, and podiatry services are not covered.
Preventive Services See details
The MyTruAdvantage Select Plus (HMO) plan covers preventive services including Medicare-covered preventive services, annual physical exams, kidney disease education services, glaucoma screenings, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a Welcome Visit. However, health education, in-home safety assessments, personal emergency response systems (PERS), medical nutrition therapy, post-discharge in-home medication reconciliation, re-admission prevention, wigs for hair loss, weight management programs, alternative therapies, therapeutic massage, adult day health services, nutritional/dietary benefits, home-based palliative care, in-home support services, support for caregivers, additional sessions of smoking and tobacco cessation counseling, enhanced disease management, telemonitoring services, remote access technologies, home and bathroom safety devices, and counseling services are not covered.
Hearing Services See details
Hearing Services includes coverage for routine hearing exams, fitting/evaluation for hearing aids, and prescription hearing aids. Routine hearing exams are covered once per year, and fitting/evaluation for hearing aids is covered 3 times with the purchase of hearing aids. Prescription hearing aids (all types) are covered with a copay between $399 and $899 for 2 visits per year, but prescription hearing aids - inner ear, outer ear, and over the ear, and OTC hearing aids are not covered.
Vision Services See details
Vision services include routine eye exams and eyewear, including contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames. Routine eye exams are unlimited, while eyewear is limited to a maximum benefit of $250.00 per year. Upgrades are not covered.
Dental Services See details
MyTruAdvantage Select Plus (HMO) offers 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, as are restorative services, adjunctive general services, endodontics, periodontics, prosthodontics (removable and fixed), implant services, and oral and maxillofacial surgery. However, maxillofacial prosthetics and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay. Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs are also covered, with a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the MyTruAdvantage Select Plus (HMO) plan, but require prior authorization. The coinsurance for dialysis services is between 20% and 20%.
Medical Equipment See details
Medical Equipment benefits are covered under the MyTruAdvantage Select Plus (HMO) plan. Durable Medical Equipment (DME) has a 20% coinsurance, while Durable Medical Equipment for use outside the home is not covered. Prosthetic Devices have a 20% coinsurance, and Medical Supplies also have a 20% coinsurance. Diabetic Therapeutic Shoes/Inserts have a 15% coinsurance, while Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including all diagnostic services and radiological services. Diagnostic Procedures/Tests have a $50 copay, Lab Services have a $10 copay, Diagnostic Radiological Services have a copay of at most $235, Therapeutic Radiological Services have a copay of at least $40, and Outpatient X-Ray Services have a $25 copay.
Home Health Services See details
Home Health Services are covered by the MyTruAdvantage Select Plus (HMO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Authorization is required for this benefit.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered by the MyTruAdvantage Select Plus (HMO) plan. The plan does not cover any of the sub-services, including Medicare-covered Intensive Cardiac Rehabilitation Services, Medicare-covered Pulmonary Rehabilitation Services, Medicare-covered Supervised Exercise Therapy (SET) for Symptomatic Peripheral Artery Disease (PAD) Services, and Additional Cardiac Rehabilitation Services.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the MyTruAdvantage Select Plus (HMO) plan with prior authorization required. 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
Other Services includes coverage for Over-the-Counter (OTC) Items, with a maximum benefit of $100 every three months, and the benefit carries over if unused, covering Nicotine Replacement Therapy (NRT) and Naloxone. Acupuncture, Meal Benefit, 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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