A non-government entity
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 2026, 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 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 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 $125.00. 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 $5500.00 (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 $5500.00 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 robust medical coverage with no copays for primary care visits, preventive services, and home health care. For inpatient hospital stays, members pay a daily copay of $390 for the first six days and no copay for days seven through 90. Outpatient services and emergency care are also covered without coinsurance, featuring predictable copays such as $35 for specialist visits and $130 for emergency room care. This plan also includes valuable supplemental benefits to help lower your out-of-pocket costs, featuring no copays for routine dental and vision exams. Members receive up to a $2,500 annual dental benefit, a $250 yearly allowance for eyewear, and a $100 over-the-counter allowance every three months that carries over if unused. Prescription hearing aids are also covered with copays ranging from $399 to $899 per device.
Inpatient Hospital See details
Red, White and Tru (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 for both acute and psychiatric Medicare-covered stays. Prior authorization is required, and upgrades, non-Medicare-covered stays, and additional psychiatric days are not covered.
Outpatient Services See details
Red, White and Tru (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 require a $35 copay with no coinsurance, while outpatient blood services are covered with no copay, no coinsurance, and no deductible.
Partial Hospitalization See details
Partial hospitalization is covered under the Red, White and Tru (PPO) plan with a $55.00 copay and no coinsurance. Prior authorization is required to receive these services.
Ambulance and Transportation Services See details
Ambulance and transportation services are covered under Red, White and Tru (PPO) with a $260 copay for ground ambulance and a $325 copay for air ambulance, with no coinsurance for either service and copays waived if you are admitted. While transportation services are technically covered, no specific transportation sub-services to health-related locations are covered in practice.
Emergency Services See details
Emergency services under the Red, White and Tru (PPO) plan are covered with a $130 copay and no coinsurance, which is waived if admitted to the hospital within 24 hours, while urgently needed services require a $35 copay and no coinsurance. Worldwide emergency, urgent, and transportation services are also covered with no coinsurance and copays ranging from $35 to $325, up to a $100,000 maximum plan benefit.
Primary Care See details
Red, White and Tru (PPO) covers primary care and opioid treatment with no copay and no coinsurance, while physical and speech therapy require a $20 copay and no coinsurance. Specialist visits, occupational therapy, and mental health services carry a $35 copay and no coinsurance, telehealth ranges from a $0 to $35 copay with no coinsurance, podiatry is not covered, and some chiropractic services are covered for a $15 copay and no coinsurance though routine and other chiropractic services are not covered.
Preventive Services See details
Preventive Services under the Red, White and Tru (PPO) plan are partially covered with no copay and no coinsurance for covered benefits like annual physical exams, kidney disease education, and select screenings. While supplemental benefits such as fitness programs and personal emergency response systems (PERS) are included, other sub-services like health education, nutritional counseling, and weight management are not covered.
Hearing Services See details
Hearing Services are partially covered under the Red, White and Tru (PPO) plan, with hearing exams and fitting evaluations covered with no copay and no coinsurance. Prescription hearing aids are covered with no coinsurance and a copay ranging from $399 to $899 for up to two devices per year, though OTC hearing aids along with inner ear, outer ear, and over the ear prescription devices are not covered.
Vision Services See details
Vision services are partially covered by Red, White and Tru (PPO) with no copay and no coinsurance, though other eye exam services and eyewear upgrades are not covered. Unlimited routine eye exams are covered, and eligible eyewear like contacts, lenses, and frames is covered up to a $250 combined in-network maximum every year.
Dental Services See details
Red, White and Tru (PPO) offers partially covered dental services with no copay and no coinsurance, up to a maximum annual benefit of $2,500 for both in-network and out-of-network care. While many preventive and comprehensive services are covered, other diagnostic dental services, other preventive dental services, maxillofacial prosthetics, and orthodontics are not covered.
Home Infusion bundled Services See details
Red, White and Tru (PPO) covers home infusion bundled services with no copay, though prior authorization is required. Medicare Part B chemotherapy, radiation, and other drugs have a coinsurance ranging from 0% to 20%, while Medicare Part B insulin is covered with a $35 copay and no coinsurance.
Dialysis Services See details
Dialysis Services are covered under the Red, White and Tru (PPO) plan with no copay and a 20% coinsurance. Prior authorization is required for these services.
Medical Equipment See details
Red, White and Tru (PPO) covers durable medical equipment and prosthetics or medical supplies with no copay and a 20% coinsurance, subject to prior authorization. Diabetic equipment is partially covered with no copay and a 15% coinsurance for therapeutic shoes and inserts, but diabetic supplies are not covered.
Diagnostic and Radiological Services See details
Diagnostic and radiological services are covered by Red, White and Tru (PPO) with no coinsurance, though prior authorization is required for diagnostic services. Members will pay a $15 copay for lab services, a $25 copay for diagnostic procedures, a $30 copay for outpatient X-rays, a $60 copay for therapeutic radiological services, and no copay for diagnostic radiological services.
Home Health Services See details
Red, White and Tru (PPO) covers Home Health Services with no copay and no coinsurance, although prior authorization is required.
Cardiac Rehabilitation Services See details
Cardiac rehabilitation services are covered under the Red, White and Tru (PPO) plan with no coinsurance. While some services are covered, cardiac, intensive cardiac, pulmonary, and SET for PAD rehabilitation services are not covered in practice and carry copayments ranging from $25 to $35.
Skilled Nursing Facility (SNF) See details
Red, White and Tru (PPO) covers Skilled Nursing Facility (SNF) services with no coinsurance, featuring no copay for days 1 through 20 and a $218 daily copay for days 21 through 100. Prior authorization is required, a prior three-day inpatient hospital stay is not required, and additional days beyond the standard 100 days are not covered.
Other Services See details
Red, White and Tru (PPO) provides partially covered other services, featuring chronic illness meal benefits and over-the-counter (OTC) items with no copay and no coinsurance. While acupuncture is not covered under this benefit, the plan includes up to $100 every three months for OTC items, which carries over if unused.
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.
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