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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 2026, please refer to our full plan details page.
MyTruAdvantage Select (HMO) is a HMO plan offered by SIHO Holding, Inc. available for enrollment in 2026 to people living in Indiana (Partial). This plan received an overall rating of 3.5 out of 5 stars in 2026.
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 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 $3300.00 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 features a drug deductible of $200. Under this plan, you will pay no copay for Tier 1 (Preferred Generic), Tier 2 (Generic), and Tier 6 (Select Care Drugs) at both preferred and standard retail pharmacies. Standard mail order options also offer no copay on three-month supplies for these same tiers, though small copays apply to shorter mail-order fills for Tiers 1 and 2. For brand-name and specialty medications, costs are structured as copays or coinsurance. Tier 3 (Preferred Brand) drugs cost $41 per month at preferred pharmacies and $47 at standard pharmacies or standard mail order. Tier 4 (Non-Preferred Brand) drugs require a 33% coinsurance across all pharmacy options, while Tier 5 (Specialty Tier) drugs require 30% coinsurance for a one-month supply.
Additional Benefits
The MyTruAdvantage Select (HMO) plan offers robust healthcare coverage with predictable out-of-pocket costs and no coinsurance for many core services. Members pay no copay for primary care visits, preventive care, and home health services, while specialist visits require a $25 copay. For inpatient hospital stays, there is a $335 daily copay for days one through six, after which there is no copay. This plan also features valuable supplemental benefits, including dental, vision, and hearing coverage with no coinsurance. Dental care is covered up to a $2,500 annual limit with no copay, and vision services include routine exams and eyewear up to a $300 limit with no copay. Additionally, members benefit from a $100 quarterly over-the-counter allowance with no copay and prescription hearing aid coverage with copays ranging from $399 to $899.
Inpatient Hospital See details
MyTruAdvantage Select (HMO) covers inpatient acute and psychiatric hospital stays with no coinsurance, requiring a $335 daily copay for days 1 to 6 and no copay for days 7 to 90. Prior authorization is required, and while unlimited additional acute days are covered, additional psychiatric days, upgrades, and non-Medicare-covered stays are not covered.
Outpatient Services See details
MyTruAdvantage Select (HMO) covers outpatient hospital services with no coinsurance and copays ranging from $25 to $250, while ambulatory surgical center and observation services require prior authorization and a $250 copay with no coinsurance. Outpatient substance abuse sessions have a $25 copay with no coinsurance, and outpatient blood services are available with no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
MyTruAdvantage Select (HMO) covers partial hospitalization with a $55.00 copay and no coinsurance. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
MyTruAdvantage Select (HMO) covers ambulance services with no coinsurance and a copay of $260 for ground transport and $325 for air transport, which is waived if you are admitted. While transportation is technically covered, only some services are covered, and transportation to plan-approved or any health-related locations is not covered.
Emergency Services See details
Emergency services are covered by MyTruAdvantage Select (HMO) with a $120 copay (waived if admitted to the hospital within 24 hours) and no coinsurance, while urgently needed care requires a $30 copay and no coinsurance. Worldwide emergency services are also covered up to a $100,000 maximum limit with no coinsurance and copays ranging from $30 to $325 depending on the service.
Primary Care See details
MyTruAdvantage Select (HMO) offers primary care and opioid treatment with no copay and no coinsurance, while specialist, mental health, and psychiatric services require a $25 copay and no coinsurance. Physical and occupational therapies require a $15 to $35 copay and no coinsurance, whereas chiropractic services are only partially covered (routine and other chiropractic services are not covered), and podiatry is not covered.
Preventive Services See details
MyTruAdvantage Select (HMO) covers preventive services with no copay and no coinsurance, including annual physicals, kidney disease education, diabetes self-management, glaucoma screenings, fitness benefits, and personal emergency response systems. This benefit is partially covered because health education, in-home safety assessments, medical nutrition therapy, medication reconciliation, readmission prevention, wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, additional smoking cessation, disease management, telemonitoring, remote access, home safety modifications, and counseling are not covered.
Hearing Services See details
Hearing services are partially covered by MyTruAdvantage Select (HMO), offering one routine hearing exam per year and unlimited fitting evaluations with no copay and no coinsurance. Up to two prescription hearing aids are covered annually with no coinsurance and a copay ranging from $399.00 to $899.00, though OTC hearing aids as well as inner ear, outer ear, and over-the-ear prescription aids are not covered.
Vision Services See details
Vision services are partially covered by MyTruAdvantage Select (HMO) with no copay, no coinsurance, and no deductible for covered services. Routine eye exams are unlimited, and eyewear—including contacts and eyeglasses—is covered up to a $300 annual maximum, though other eye exam services and eyewear upgrades are not covered.
Dental Services See details
Dental Services are partially covered by MyTruAdvantage Select (HMO) with no copay and no coinsurance up to a $2,500 annual maximum. While many preventive and comprehensive services are included, orthodontics, maxillofacial prosthetics, and other preventive dental services are not covered.
Home Infusion bundled Services See details
Home infusion bundled services are covered by MyTruAdvantage Select (HMO) with no copay, though prior authorization and step therapy are required. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while other Part B chemotherapy, radiation, and miscellaneous drugs require a 0% to 20% coinsurance.
Dialysis Services See details
Dialysis services are covered by MyTruAdvantage Select (HMO) with no copay and a 20% coinsurance. Prior authorization is required to receive these services.
Medical Equipment See details
Medical equipment is covered by MyTruAdvantage Select (HMO) with no copays, though durable medical equipment and prosthetics require prior authorization and a 20% coinsurance. Diabetic equipment is partially covered, offering diabetic therapeutic shoes and inserts at a 15% coinsurance, while diabetic supplies are not covered.
Diagnostic and Radiological Services See details
MyTruAdvantage Select (HMO) covers diagnostic and radiological services with no coinsurance, although lab services are not covered. Diagnostic procedures and outpatient X-rays require a $25 copay, therapeutic radiological services require a $40 copay, and diagnostic radiological services are covered with no copay.
Home Health Services See details
Home health services are covered under the MyTruAdvantage Select (HMO) plan with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are not covered in practice under MyTruAdvantage Select (HMO), as intensive cardiac, pulmonary, and supervised exercise therapy (SET) services are all excluded from coverage despite a listed benefit of no coinsurance.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) care is covered by MyTruAdvantage Select (HMO) with no coinsurance, requiring prior authorization but no prior three-day inpatient hospital stay. You will pay no copay for days 1 through 20 and a $218 daily copay for days 21 through 100, though additional days beyond the standard Medicare-covered limit are not covered.
Other Services See details
Other Services are partially covered under the MyTruAdvantage Select (HMO) plan, featuring no copay and no coinsurance for Over-the-Counter (OTC) items and chronic illness meal benefits, while acupuncture is not covered. The OTC benefit provides up to $100 every three months with no copay and no coinsurance.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
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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.
* Benefit(s) mentioned may be part of a special supplemental program for chronically ill members with one of the following conditions: Diabetes mellitus, Cardiovascular disorders, Chronic and disabling mental health conditions, Chronic lung disorders, Chronic heart failure. This is not a complete list of qualifying conditions. Having a qualifying condition alone does not mean you will receive the benefit(s). Other requirements may apply.
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