IU Residents
Medical

On this page: Medical | Prescription drugs | Mental health | Vision

Medical Plan

The plan is administered by Anthem and is available to all eligible Residents, regardless of area of residence. When network providers are used, participants receive full benefits. Partial benefits are received from non-network providers, except in the case of an emergency. Network providers include Anthem Blue Access PPO providers in Indiana, Ohio, and Kentucky and BCBS Blue Card providers in other states.

Medical Plan Highlights

  • Anthem's national PPO network; includes PPO providers and coverage outside of the US
  • Annual deductible of $350 ($1,050 family)
  • Office visit copay of $25, Specialist visit copay of $40
  • Urgent Care copay of $75, Emergency Room copay of $150
  • Preventative services covered at 100% when in-network providers are used
  • Most other services covered with 20% coinsurance
  • Vision care coverage through Anthem Blue View Vision, including an annual eye exam with a $20 copay and discounts for vision wear
  • CVS Caremark national pharmacy networks, mail order service, and specialty pharmacy
    • Up to a 30-day retail prescription copays of $10 generic/$25 preferred brands/$75 non-preferred brands
    • Up to a 90-day mail order prescription copays of $25 generic/$60 preferred brands/$180 non-preferred brand
  • Plan year begins each January; deductibles and out-of-pocket amounts restart annually on January 1st
  • Premiums for eligible Residents and qualifying dependents are fully paid by the affiliated hospitals through the School of Medicine Office of Graduate Medical Education.

Publications

Forms

Useful info and tips

Things you can do…

  • Download a PDF of the 2019 Medical Plan Summary for information about services, copays, and deductibles.
  • Download a PDF of the 2019 Summary of Benefits and Coverage (SBC) in the Healthcare Reform format.
  • Contact Anthem customer service at 844-736-0920 or visit the Anthem Web site for questions about coverage, claims, and provider networks.
  • Locate a network medical provider by consulting the Anthem Provider Directory.
  • Obtain information about precertification of a medical procedure by calling Anthem Pre Certification at 866-643-7087.

Prescription Drugs (Rx)

This medical plan's prescription benefit includes medications available on the CVS Caremark Formulary, which may offer potential savings when a physician prescribes formulary medications.

Things you can do…

Mental Health and Chemical Dependency

This medical plan offers full benefits from Anthem Behavioral Health network providers. Partial benefits are received from non-network providers. All services must be authorized in advance in order to be covered.

Things you can do…

  • Download a PDF of the 2019 Medical Plan Summary for information about services, copays, and deductibles.
  • Contact Anthem customer service at 844-736-0920 for questions about coverage, claims and provider networks.

Vision

This medical plan's vision program is Blue View Vision-Exam Plus Option #5.  Anthem has an extensive nationwide network of doctors who provide quality eye care and materials. When you are seen by a participating doctor, your plan covers an eye examination, less any applicable copayment. You may also purchase eyeglass frames, lenses, and contact lenses at a discount.

Things you can do…

  • Download a PDF of the Vision Plan Summary for information about services, copays, and deductibles.
  • Contact Anthem customer service at 866-723-0515 for questions about coverage, claims, and provider networks.