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2018 Medical Care Plans Comparison Chart

IU Health HDHP
Anthem PPO HDHP
Anthem PPO $500 Deductible
Network Availability
Most Indiana counties. Visit iuhealthplans.org for a provider directory.
Nationwide and Overseas
Nationwide and Overseas
Provider Network
Only from IU Health network providers
Anthem Blue Access and Blue Card PPO providers
Anthem Blue Access and Blue Card PPO providers
HSA Contributions

IU Contribution:
$1,600 employee-only coverage
$3,200 all other coverage levels
Contribution is deposited with the employees' 2nd paycheck in January

Employee Contribution:
Minimum $300 ($25 monthly)
Maximum $1,850 employee-only / $3,700 all other coverage levels
For those age 55+, additional $1,000 catch-up

IU Contribution:
$1,300 employee-only coverage
$2,600 all other coverage levels
Contribution is deposited with the employees' 2nd paycheck in January

Employee Contribution:
Minimum $300 ($25 monthly)
Maximum $2,150 employee-only / $4,300 all other coverage levels
For those age 55+, additional $1,000 catch-up

Not applicable.
Medical
In-Network Benefits
Deductibles $2,500 employee-only coverage
$5,000 all other coverage levels
$1,350 employee-only coverage
$2,700 all other coverage levels
$500 for each individual
$1,500 family maximum
Coinsurance 20% after the deductible is met 20% after the deductible is met 20% after the deductible is met
Out-of-Pocket Maximum $3,000 employee-only coverage
$6,000 all other coverage levels
$2,700 for employee-only coverage
$5,400 all other coverage levels
$2,400 for each individual
$7,200 for family maximum
In-Network Preventive Services
Plan pays 100%.
Plan pays 100%. Plan pays 100%.
Emergency Room
20% coinsurance after deductible
20% coinsurance after deductible.
$150 copay per visit (waived if admitted).
Urgent Care In-Network: 20% coinsurance after deductible
Out-of-Network: Paid as in-network when 50+ miles from home
In-Network: 20% coinsurance after deductible
Out-of-Network: 40% coinsurance after deductible
In-Network: $75 copay
Out-of-Network: 40% coinsurance after deductible
Mental Health Covered as any other illness through IU Health network providers. Prior authorization is required.
Covered as any other illness through Anthem Behavioral Health. Prior authorization is required.
Covered as any other illness through Anthem Behavioral Health. Prior authorization is required.
Out-of-Network Benefits
Deductibles No out-of-network benefits, except emergency. $2,700 employee-only coverage
$5,400 all other coverage levels
$900 for each individual
$2,700 family maximum
Co-insurance 40% coinsurance after deductible 40% after the deductible is met
Out-of-Pocket Maximum $5,400 employee-only coverage
$10,800 all other coverage levels
$6,850 for each individual
$13,700 for family maximum
Prescription Drugs
In-Network Benefits

Retail (up to 30-day supply):
20% coinsurance after deductible

Retail at CVS Pharmacies
(up to 90-day supply):
20% coinsurance after deductible

Mail Order (up to 90-day supply) & Specialty:
20% after deductible

Preventive Rx not subject to the deductible.

Retail (up to 30-day supply):
20% coinsurance after deductible

Retail at CVS Pharmacies
(up to 90-day supply):
20% coinsurance after deductible

Mail Order (up to 90-day supply) & Specialty:
20% after deductible

Preventive Rx not subject to the deductible.

Retail (up to 30-day supply):
Tier 1 - $8 / Tier 2 - $25 / Tier 3 - $45

Mail Order at CVS
(up to 90-day supply):
Tier 1 - $20 / Tier 2 - $62 / Tier 3 - $112

Mail Order & Specialty
(up to 90-day supply):
Tier 1 - $20 / Tier 2 - $62 / Tier 3 - $112

Out-of-Pocket Max:
$4,250 employee-only coverage / $6,100 all other coverage levels

Preventive Prescription Exceptions (In-Network Only) All plans pay 100% for generic contraceptives, pediatric sodium fluoride, low dose aspirin, folic acid, Vitamin D for age 65 and older, Tamoxifen, Raloxifene, and iron. 100% coverage for tobacco cessation products and nicotine replacement (up to 180-day supply annually). Over the counter products require a prescription for coverage.
Out-of-Network Benefits No coverage.

Retail (up to 30-day supply): 40% coinsurance after deductible

Mail Order (up to 90-day supply) & Specialty: No Coverage

Retail (up to 30-day supply): 50% coinsurance after deductible

Mail Order (up to 90-day supply) & Specialty: No Coverage

Vision Care
Exams and Eyewear Routine eye exam ($10 copay) & eyewear (frames, lenses, or contacts) with specific allowances. IU Health members use EyeMed network & ID card; Anthem members use Blue View Vision network & Anthem ID card.

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