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2018 Anthem PPO High Deductible Health Plan (Anthem PPO HDHP)

The Anthem Preferred Provider Organization High Deductible Health Plan (Anthem PPO HDHP) includes comprehensive coverage for medical, prescriptionvision, behavioral health, and organ transplant services with no pre-existing condition limits or waiting periods. When you elect the Anthem PPO HDHP, you are also eligible to elect a Health Savings Account (HSA), a special tax-advantaged bank account to help cover out-of-pocket costs.

Top FAQs Customer Service Resources & Forms

Plan Basics

Overview

This plan combines traditional medical coverage with a Health Savings Account (HSA), which gives you greater flexibility and discretion over how you use your health care dollars. With this plan, the annual deductible must be met before plan benefits are paid for services other than in-network preventive care, which is covered at 100%. You may visit any doctor or hospital, but you receive a higher level of benefits when you use Blue Access PPO providers.

Monthly Premiums

Monthly Employee Contribution
Employee’s Annual Base Salary*
Below $35K
$35K -
$59K
$60K -
$99K
$100K -
$149K
$150K -
$199K
$200K -
$249K
$250K
and Above
Employee-only
$38.65
$51.73
$67.44
$84.95
$103.12
$125.59
$145.75
Employee & child(ren)
$73.44
$98.28
$128.15
$161.41
$195.93
$238.61
$276.93
Employee & spouse
$102.43
$137.07
$178.73
$225.13
$273.28
$332.80
$386.24
Family
$115.96
$155.18
$202.33
$254.86
$309.37
$376.76
$437.25

* The employee’s salary band is determined by the annual base salary at the time payroll runs each month. For School of Medicine full-time faculty who receive a portion of their pay from an IU Health or VA paycheck, annual base salary includes both IU base salary and certain IU Health fixed and/or variable compensation, as determined by the School of Medicine.

K=1,000

Employee contributions are deducted before taxes.

Subtract $25 per month for an employee or spouse ($50 for both) who do not use tobacco and complete a tobacco-free affidavit.

Annual Deductible

The deductible is the amount you must pay out of pocket before the plan will begin to pay benefits. The deductible applies to all medical services and prescriptions except wellness/preventive. When one or more family members are covered, the family deductible must be met before services are covered for any member.

In-Network: $1,350 for employee-only coverage / $2,700 all other coverage levels
Out-of-Network: $2,700 for employee-only coverage / $5,400 all other coverage levels

Network and Non-Network deductibles are separate and do not accumulate toward each other.

Coinsurance

Coinsurance is the percent of a covered health care service you pay after you have paid your deductible. For example, if your coinsurance is 20%, you pay 20% of the cost and the plan will pay the other 80%.

In-Network: 20% after deductible
Out-of-Network: 40% after deductible

Out-of-Pocket Maximum

The out-of-pocket maximum is the most you will have to pay during a policy period for health care services. Once you have reached your out-of-pocket maximum, the plan begins to pay 100% of the allowed amount for covered services. All coinsurances and deductibles apply towards this maximum.

In-Network: $2,700 for employee-only coverage/$5,400 all other coverage levels
Out-of-Network: $5,400 for employee-only coverage/$10,800 all other coverage levels

Network and Non-Network out-of-pocket maximums are separate and do not accumulate toward each other.

Prescription Benefit

Retail (up to 30-day supply)
In-Network: 20% after deductible
Out-of-Network: 40% after deductible

Retail at CVS Pharmacy (up to 90-day supply)
In-Network: 20% after deductible

Mail Order (up to 90-day supply) and Specialty
In-Network: 20% after deductible
Out-of-Network: Not covered

There is no coinsurance or deductible on most contraceptives, and no deductible on preventive prescriptions.

Additional Services

The following programs are a part of the Anthem PPO HDHP Plan:

Sometimes you just need a doctor. Using the Internet, you can connect to one anytime, anywhere – whether it is the middle of the night or the middle of a road trip. Sign up for LiveHealth Online and have a face-to-face conversation on your computer or mobile device.

Web site

Flyer (PDF)

Identity protection is available when you have active medical coverage with Anthem. If there is an issue with your identity, just call AllClear ID. A dedicated investigator will help you recover financial losses, restore your credit, and help return your identity to its proper condition.

Web site

Flyer (PDF)

Saving money is good. Saving money on things that are good for you is even better. With SpecialOffers, you can get discounts on products and services that help promote better health and well-being.

Flyer (PDF)

Learn more in the Plan Summary Chart (PDF)

 

Top Frequently Asked Questions

Below are answers to the most frequently asked questions regarding the Anthem PPO HDHP.  

Where can I find my Anthem ID Card?

Once your enrollment in the plan has been processed, Anthem will mail you an official membership packet and ID card(s).

If you need proof of coverage before your permanent card arrives, you can print a temporary ID card (PDF).

If you’ve lost your permanent ID card, you can request a new one by logging on to Anthem and choosing the “Request an ID card” link, or by calling Anthem Customer Service at 844-736-0920.

What is a Health Savings Account (HSA)? 

The Health Savings Account (HSA) is a tax-advantaged bank account that can be used to pay for IRS-qualified health expenses for you, your spouse, and your tax dependents. Enrollment in the Anthem PPO HDHP or the IU Health HDHP allows enrollment in the HSA. For more information, visit the Health Savings Account page.

What are preventive services?

Preventive services are covered at no cost when network providers are used. Preventive services include physical exams, well-child visits, immunizations, lab tests (e.g., Pap, PSA, cholesterol), contraceptive services (e.g., IUD’s and sterilization), and other screening diagnostic services like mammograms and colonoscopies. You can view the Summary of Preventive Services (PDF) or call Anthem Customer Service for more information.

How do I find a health care provider?

The plan uses Anthem Blue Access in Indiana and Blue Cross & Blue Shield (“Blue Card” providers) in other states and overseas. Once enrolled in the plan, you can use the Castlight Health tool or logon to Anthem to find in-network providers.

What pharmacies can I use?

CVS Caremark pharmacy network includes most retail chain pharmacies, such as CVS, Walmart, Target, and most supermarket and club pharmacy chains. To locate network pharmacies, check prescription coverage and costs visit the www.Caremark.com or the Caremark app.

Does the plan include Vision Wear coverage?

Yes. Vision Wear coverage is provided through Anthem Blue View Vision. Coverage is included in your enrollment in the medical plan, but vision services have their own schedule of benefits and network providers separate from medical benefits. Visit the Vision Wear benefit page for more information.

More Anthem HDHP FAQs

 

Customer Service Contacts

Medical - Anthem
Member Services: 844-736-0920
www.anthem.com (select Blue Access PPO)
BlueCard network providers outside of Indiana:
800-810-2583 or www.bcbs.com

Prescription - CVS Caremark
Member Services: 866-234-6952
Mail Order Services: 866-234-6952
www.caremark.com

Vision - Anthem Blue View Vision
Member Services: 866-723-0515
www.anthem.com

Health Savings Account – The Nyhart Company
Member Services: 800-284-8412
Email: 
iu.nyhart.com (available after account is opened)

IU Human Resources
Benefit Questions: 812-856-1234
Benefit Email: