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Red, White and Tru (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for Red, White and Tru (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on Red, White and Tru (PPO) in 2025, please refer to our full plan details page.
Red, White and Tru (PPO) is a PPO 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 Red, White and Tru (PPO) is a Medicare Advantage (MA) Plan without drug coverage. That means that this plan covers medical services but doesn't cover prescription drugs. If you are looking for a plan with prescription drug coverage, please search for other MA and PDP plans offered in your area.
Key Plan Facts
Below are a few key facts and commonly-asked questions about Red, White and Tru (PPO).
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 Red, White and Tru (PPO), 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. Additionally, this plan comes with a Part B Premium reduction of $75.00. You must continue to pay paying your reduced Part B Premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
Drugs are not covered by this plan, so a prescription drug deductible is not applicable.
Out-of-Pocket Maximums
This plan has a combined Maximum Out-Of-Pocket cost of $4000.00 (in-network or out-of-network combined). You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $4000.00 for covered services, the plan will pay 100% of covered costs for the rest of the year.
The plan may have separate out-pocket-maximums for in-network and out-of-network services. See our full plan details page for more information.
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
Prescription drugs are not covered by Red, White and Tru (PPO).
Additional Benefits
The Red, White and Tru (PPO) plan offers a range of benefits with varying costs. Inpatient hospital stays have a copay, and outpatient services have copays ranging from $35 to $350. Emergency, primary care, and preventive services are covered, with some services having a copay and others with no copay. The plan also includes coverage for hearing, vision, and dental services, with specific allowances and copays. Home infusion, dialysis, and medical equipment are covered with coinsurance or copays, and skilled nursing facility services have a copay after the first 20 days. Other services include ambulance, home health, and diagnostic services.
Inpatient Hospital See details
Inpatient Hospital benefits, including Acute and Psychiatric, are covered under the Red, White and Tru (PPO) plan. For Inpatient Hospital-Acute, there is a $390 copay for days 1-5, and no copay for days 6-90. Inpatient Hospital Psychiatric has a $390 copay for days 1-5, and no copay for days 6-90. Additional days for Inpatient Hospital-Acute are covered, while Non-Medicare-covered stays and Upgrades for Inpatient Hospital-Acute are not covered. Additional days and Non-Medicare-covered stays for Inpatient Hospital Psychiatric are also not covered.
Outpatient Services See details
Outpatient Services are covered by the Red, White and Tru (PPO) plan, including all outpatient hospital services, outpatient substance abuse services, and outpatient blood services. Outpatient hospital services have a copay between $35 and $350, observation services and ambulatory surgical center services have a $325 copay, and individual and group sessions for outpatient substance abuse have a $35 copay.
Partial Hospitalization See details
Partial Hospitalization is covered by the Red, White and Tru (PPO) plan, with a $55 copay. Prior authorization is required for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered under the Red, White and Tru (PPO) plan. Ground ambulance services have a $260 copay, while air ambulance services have a $325 copay, and both have no coinsurance. Transportation services to health-related locations are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Services are covered by the Red, White and Tru (PPO) plan. Emergency Services has a $140 copay, and Urgently Needed Services has a $35 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
The Red, White and Tru (PPO) plan covers Primary Care benefits, including 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. Chiropractic Services have a $20 copay, Physician Specialist Services have a $35 copay, Occupational Therapy has a $35 copay, Physical Therapy and Speech-Language Pathology Services have a $35 copay, and Additional Telehealth Benefits have a copay between $0 and $35. Routine Chiropractic Care and Podiatry Services are not covered.
Preventive Services See details
The Red, White and Tru (PPO) plan covers preventive services, including annual physical exams, with no copay. Additional preventive services are partially covered, with Health Education, In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), Post discharge In-Home Medication Reconciliation, Re-admission Prevention, Wigs for Hair Loss Related to Chemotherapy, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefit, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, Additional Sessions of Smoking and Tobacco Cessation Counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies (including Web/Phone-based technologies and Nursing Hotline), Home and Bathroom Safety Devices and Modifications, and Counseling Services not covered.
Hearing Services See details
Hearing services include routine hearing exams and fitting/evaluation for hearing aids, and are covered by the Red, White and Tru (PPO) plan. Routine hearing exams are covered once per year, and the fitting/evaluation for hearing aids is covered for 3 visits with the purchase of hearing aids. Prescription hearing aids are partially covered, with a copay between $399 and $899 for Prescription Hearing Aids (all types); Prescription Hearing Aids - Inner Ear, Outer Ear, and Over the Ear are not covered, and OTC hearing aids are also not covered.
Vision Services See details
Vision services are covered by the Red, White and Tru (PPO) plan, including routine eye exams, contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames, with no deductible. The plan provides a maximum benefit of $250 per year for eye exams, and upgrades are not covered.
Dental Services See details
The Red, White and Tru (PPO) plan offers dental services with a maximum benefit of $1750 per year, covering services like oral exams (2 per year), dental x-rays (1 per year), and cleanings (2 per year). Maxillofacial Prosthetics and Orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered by the Red, White and Tru (PPO) 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 by the Red, White and Tru (PPO) plan, but require prior authorization. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical equipment is covered by the Red, White and Tru (PPO) plan. Durable Medical Equipment (DME) has a 20% coinsurance, and requires authorization. Prosthetic Devices and Medical Supplies have a 20% coinsurance, and require authorization. Diabetic Therapeutic Shoes/Inserts have a 15% coinsurance, and authorization is required. Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered by the Red, White and Tru (PPO) plan. Diagnostic Procedures/Tests have a $25 copay, while Lab Services have a $15 copay. Diagnostic Radiological Services have a maximum copay of $235, Therapeutic Radiological Services have a $60 copay, and Outpatient X-Ray Services have a $30 copay.
Home Health Services See details
Home Health Services are covered by the Red, White and Tru (PPO) plan with no copay and no coinsurance, but prior authorization is required. Additional Hours of Care and Personal Care Services are not covered.
Cardiac Rehabilitation Services See details
Cardiac Rehabilitation Services are generally covered, but the specific 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 are not covered. There is a copay for some services, but more details are needed to determine the exact cost.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the Red, White and Tru (PPO) plan with prior authorization required. For days 1-20, there is no copay, and for days 21-100, the copay is $214.
Other Services See details
Other Services are partially covered by the Red, White and Tru (PPO) plan; 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. Over-the-Counter (OTC) Items are covered with a maximum benefit of $75 every three months, and unused benefits carry over to the next period.
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