A non-government entity
MyTruAdvantage Choice Plus (PPO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for MyTruAdvantage Choice Plus (PPO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on MyTruAdvantage Choice Plus (PPO) in 2026, please refer to our full plan details page.
MyTruAdvantage Choice Plus (PPO) is a PPO 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 out of 5 stars in 2026.
It's important to know that MyTruAdvantage Choice Plus (PPO) 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 Choice Plus (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 MyTruAdvantage Choice Plus (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.
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 $300.00 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 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:
Sign up for MyTruAdvantage Choice Plus (PPO)
Need help deciding? Talk with one of our licensed insurance specialists 1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
Drug Coverage
The MyTruAdvantage Choice Plus (PPO) plan features an annual drug deductible of $300. Beneficiaries enjoy no copay for Tier 1 preferred generic, Tier 2 generic, and Tier 6 select care drugs when filled at either preferred or standard pharmacies. Standard mail order options also offer no copay for three-month supplies of these generic and select care drugs, though small copays apply for shorter generic shipments. For Tier 3 preferred brand drugs, one-month copays start at $41 at preferred pharmacies and $47 at standard pharmacies or standard mail order. Tier 4 non-preferred brands require a 28% coinsurance, while Tier 5 specialty drugs carry a 29% coinsurance for a one-month supply.
Additional Benefits
The MyTruAdvantage Choice Plus (PPO) plan offers robust coverage for essential medical needs with predictable out-of-pocket costs and no coinsurance for many services. You will enjoy no copay for primary care visits, preventive services, and home health care, while specialist visits and outpatient hospital services carry affordable copays starting at $35. For inpatient hospital stays, there is a $390 daily copay for the first six days and no copay for subsequent days up to day 90. This plan also features excellent supplemental benefits, including routine dental and vision care with no copay or coinsurance, alongside a $2,000 annual maximum for dental services and a $250 annual allowance for eyewear. Prescription hearing aids are covered with copays ranging from $399 to $899, and Medicare Part B insulin drugs are capped at a $35 copay with no coinsurance. Additionally, members receive a quarterly $100 allowance for over-the-counter items with no copay or coinsurance.
Inpatient Hospital See details
MyTruAdvantage Choice Plus (PPO) partially covers inpatient hospital services with no coinsurance, requiring a $390 daily copay for days 1 through 6 and no copay for days 7 through 90. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
MyTruAdvantage Choice Plus (PPO) covers outpatient services with no coinsurance, featuring copays ranging from $35 to $350 for outpatient hospital services and $325 for ambulatory surgical center and observation services. Outpatient substance abuse sessions carry a $35 copay with no coinsurance, while outpatient blood services are covered with no copay, coinsurance, or deductible.
Partial Hospitalization See details
MyTruAdvantage Choice Plus (PPO) covers partial hospitalization services with a $55.00 copay and no coinsurance. Prior authorization is required to receive coverage for these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered by MyTruAdvantage Choice Plus (PPO) with no coinsurance, requiring a $260 copay for ground ambulance and a $325 copay for air ambulance, which are waived if you are admitted. While some transportation services are covered, trips to plan-approved health-related locations and any health-related locations are not covered.
Emergency Services See details
MyTruAdvantage Choice Plus (PPO) covers emergency services with a $150 copay—which is waived if you are admitted to the hospital within 24 hours—and urgently needed services with a $35 copay, both featuring no coinsurance. Worldwide emergency, urgent, and transportation services are also covered up to a $100,000 maximum benefit with no coinsurance and copays ranging from $35 to $325.
Primary Care See details
MyTruAdvantage Choice Plus (PPO) covers primary care and opioid treatment services with no copay and no coinsurance, while specialist, mental health, and occupational therapy services require a $35 copay and no coinsurance. Physical therapy and chiropractic services have a $20 copay and no coinsurance, though routine chiropractic and podiatry services are not covered. Telehealth benefits are also available with a $0 to $35 copay and no coinsurance.
Preventive Services See details
Preventive services are covered by MyTruAdvantage Choice Plus (PPO) with no copay and no coinsurance, including annual physical exams, kidney disease education, and diabetes self-management. Additional preventive services are partially covered, providing physical and memory fitness benefits with no copay and no coinsurance, but excluding health education, in-home safety assessments, personal emergency response systems, medical nutrition therapy, post-discharge medication reconciliation, readmission prevention, chemotherapy wigs, weight management, alternative therapies, therapeutic massage, adult day health, nutritional benefits, palliative care, in-home support, caregiver support, tobacco cessation counseling, disease management, telemonitoring, remote access technologies, home safety modifications, and counseling.
Hearing Services See details
Hearing services are partially covered by MyTruAdvantage Choice Plus (PPO), offering routine exams and fittings with no copay and no coinsurance. Prescription hearing aids are covered with no coinsurance and a copay ranging from $399.00 to $899.00, but OTC, inner ear, outer ear, and over the ear hearing aids are not covered.
Vision Services See details
MyTruAdvantage Choice Plus (PPO) provides partially covered vision services with no copay, no coinsurance, and no deductible for routine eye exams and eyewear. In-network eyewear is covered up to a $250 annual maximum, though other eye exam services and eyewear upgrades are not covered.
Dental Services See details
Dental services are partially covered by MyTruAdvantage Choice Plus (PPO) with no copay and no coinsurance for covered services up to a $2,000 annual maximum. While many preventive and comprehensive services are included, other diagnostic dental, other preventive dental, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
MyTruAdvantage Choice Plus (PPO) covers home infusion bundled services with no copay, requiring prior authorization and step therapy. Under this benefit, Medicare Part B insulin drugs have a $35 copay and no coinsurance, while Medicare Part B chemotherapy, radiation, and other drugs require no copay and 0% to 20% coinsurance.
Dialysis Services See details
Dialysis Services are covered by MyTruAdvantage Choice Plus (PPO) with no copay and a 20% coinsurance, though prior authorization is required.
Medical Equipment See details
Medical equipment is covered by MyTruAdvantage Choice Plus (PPO) with no copays, featuring a 20% coinsurance for durable medical equipment, prosthetic devices, and medical supplies, and a 15% coinsurance for diabetic therapeutic shoes and inserts. This benefit is partially covered, as diabetic supplies are not covered.
Diagnostic and Radiological Services See details
MyTruAdvantage Choice Plus (PPO) covers diagnostic and radiological services with no coinsurance. Diagnostic procedures and tests carry a $25 copay, lab services carry a $15 copay, outpatient X-rays carry a $30 copay, therapeutic radiology has a minimum $60 copay, and diagnostic radiology features no copay.
Home Health Services See details
MyTruAdvantage Choice Plus (PPO) covers Home Health Services with no copay and no coinsurance, though prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are not covered under the MyTruAdvantage Choice Plus (PPO) plan, including intensive cardiac, pulmonary, and supervised exercise therapy (SET) rehabilitation.
Skilled Nursing Facility (SNF) See details
MyTruAdvantage Choice Plus (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance and no prior three-day hospital stay required, though prior authorization is necessary. There is no copay for days 1 through 20, a $218 daily copay for days 21 through 100, and additional days beyond the Medicare-covered limit are not covered.
Other Services See details
MyTruAdvantage Choice Plus (PPO) provides partial coverage for other services, including over-the-counter items with no copay and no coinsurance up to $100 every three months, and a chronic illness meal benefit with no copay and no coinsurance. Acupuncture and other additional services under this benefit category are not covered.
Get Personalized Help from a licensed insurance agent
1-877-649-2073 / TTY 711. 8am-11pm EST. 7 days a week
*/SMID: MULTIPLAN_HCIHNMEDADVRX25_HCI_M
MedicareAdvantageRX.com is owned and operated by Dog Media Solutions LLC.
This is a promotional communication.
Every year, Medicare evaluates plans based on a 5-star rating system.
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.
Enrollment in Medicare/Medicare Advantage may be limited to certain times of the year unless you qualify for a Special Enrollment Period
We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.
We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan's contract renewal.
Not all plans offer all of these benefits. Benefits may vary by carrier and location. Limitations and exclusions may apply.
Please contact Medicare.gov ,1-800-MEDICARE , or your local State Health Insurance Program (SHIP) to get information on all of your options.
Medicare has neither approved nor endorsed any information on this site.
Speak with a licensed insurance agent: 1-877-649-2073 / TTY 711 | 8am - 11pm ET | 7 days a week
© 2023 Dog Media Solutions LLC. All rights reserved