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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, including coverage for inpatient and outpatient services, with varying copays. You'll find no copay for days 6-90 of inpatient hospital stays, and copays for services like emergency care, primary care, and vision. This plan also includes coverage for dental, hearing, and home health services, as well as medical equipment. There is a maximum benefit for dental and vision services, and additional benefits like over-the-counter items.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, but Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered. For Inpatient Hospital-Acute, you will pay a copay of $390 for days 1-5, and no copay for days 6-90. For Inpatient Hospital Psychiatric, you will pay a copay of $390 for days 1-5, and no copay for days 6-90.
Outpatient Services See details
Outpatient Services are covered by the Red, White and Tru (PPO) plan, including outpatient hospital services, observation services, ambulatory surgical center 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 by the Red, White and Tru (PPO) 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 by the Red, White and Tru (PPO) plan. Emergency Services have a $140 copay, while Urgently Needed Services have 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 physician services, chiropractic services (with a $20 copay), occupational therapy services (with a $35 copay), physician specialist services (with a $35 copay), mental health specialty services (with a $35 copay), other health care professional services (with a $35 copay), psychiatric services (with a $35 copay), physical therapy and speech-language pathology services (with a $35 copay), additional telehealth benefits (with a $0-$35 copay), and opioid treatment program services. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
The Red, White and Tru (PPO) plan covers preventive services including Medicare-covered services, annual physical exams, and additional services like glaucoma screenings and diabetes self-management training. However, services like health education, in-home safety assessments, and several others are not covered.
Hearing Services See details
Hearing exams, including routine hearing exams and fitting/evaluation for hearing aids, are covered by the Red, White and Tru (PPO) plan. Routine hearing exams are covered once per year, and fitting/evaluation for hearing aids is covered up to three times with the purchase of hearing aids. Prescription hearing aids are partially covered, with a copay between $399 and $899, while inner ear, outer ear, and over the ear prescription hearing aids, as well as OTC hearing aids, are not covered.
Vision Services See details
Vision Services includes coverage for routine eye exams, contact lenses, eyeglasses (lenses and frames), and eyeglass lenses, with no deductible. This plan also covers eyeglass frames, and has a maximum benefit of $250.00 every year for both in-network and out-of-network services, but does not cover upgrades.
Dental Services See details
The Red, White and Tru (PPO) plan covers dental services with a maximum benefit of $1750 per year, including oral exams (2 per year), dental x-rays (1 per year), prophylaxis (cleaning) (2 per year), and fluoride treatment (2 per year). Restorative services, implant services, prosthodontics (removable and fixed), and oral and maxillofacial surgery are also covered with visit limits and periodicity restrictions, while 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, but require prior authorization. For Medicare Part B Insulin Drugs, there is a $35 copay. For Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs, coinsurance may range from 0% to 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 benefits include Durable Medical Equipment (DME) with a 20% coinsurance and Prosthetics/Medical Supplies with no copay and a coinsurance for Medicare-covered devices and supplies. Diabetic Equipment benefits are also covered, including Diabetic Therapeutic Shoes/Inserts with a 15% coinsurance, but Diabetic Supplies and Durable Medical Equipment for use outside the home 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 copay of up to $235, Therapeutic Radiological Services have a copay of at least $60, 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 not covered by the Red, White and Tru (PPO) plan. Some services are covered, 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 Red, White and Tru (PPO) plan, but require 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 for SNF are not covered.
Other Services See details
Other Services include coverage for Over-the-Counter (OTC) Items, with a maximum benefit of $75 every three months, and this plan also offers Nicotine Replacement Therapy (NRT) and Naloxone as Part C OTC benefits. 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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