Fellowship Recipients
Medical
On this page: Medical | Prescription drugs | Mental health | Vision
Effective July 1, 2019, prescription coverage for Fellowship Recipients will be managed by IngenioRx, Anthem’s new pharmacy benefit manager. No changes are being made to the drug formulary (what’s covered under your plan) as a result of the transition.
In May, you received a welcome letter introducing you to IngenioRx. Your current Anthem insurance card can continue to be used and if you have a current prior authorization, it will remain in place. Anthem also sent targeted letters in May to both members who use home delivery and who fill specialty medications through Accredo to provide information on how you will be transitioned to IngenioRx pharmacies. Please refer to these letters for more information and steps to take to ensure you can fill your medication on or after July 1.
If you have a problem filling a prescription after July 1, you can call member services at 800-345-2460. This number is also on the back of your ID card.
For more information and to ensure you have the right ID card to fill prescriptions, visit this FAQ on IngenioRx (PDF).
Medical Plan
The plan is administered by Anthem and is available to all eligible Fellowship Recipients, regardless of area of residence. Network providers include Anthem Blue Access PPO and BCBS Blue Card providers in other states. When network providers are used, plan members have lower out-of-pocket expenses. Plan members who receive out-of-network services have higher out-of-pocket expenses, except in the case of an emergency.
Medical Plan Highlights
- Anthem's national PPO network; includes PPO providers and coverage outside of the US
- No annual deductible
- Office visit copay of $25, Specialist visit copay of $35
- Urgent Care copay of $50, 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
- Anthem Prescription Management national pharmacy retail networks, mail order, and specialty pharmacy services
- Up to a 30-day retail prescription copays of $8 generic/$25 preferred brands/$45 non-preferred brands
- Up to a 90-day mail order prescription copays of $20 generic/$62 preferred brands/$112 non-preferred brand
- Plan year begins each January; deductibles and out-of-pocket amounts restart annually on January 1st
Publications
Forms
Resources
Fellowship Recipient Premium
Premiums for qualifying Fellowship Recipients are fully paid by the University.
Fellowship Recipient | |||
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^The Spring premium is for January 1 – July 31 and the Fall premium is for August 1 – December 31. The rate includes both medical and dental coverage. |
Dependent Premiums
Premium |
Premium |
Premium |
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2019 | |||
Spouse* | |||
Child(ren)* | |||
2020 | |||
Spouse* | |||
Child(ren)* | |||
*Dependent premium rates are paid for by the Fellowship Recipient on a monthly basis to IU Human Resources. See the Eligibility and Enrollment Guidelines to verify if your dependent qualifies. |
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 in the Healthcare Reform format.
- Contact Anthem customer service at 800-345-2460 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 Utilization Review at 877-814-4803.
Prescription Drugs (Rx)
This medical plan's prescription benefit includes medications available on the Anthem Prescription Benefit Formulary, which may offer potential savings when a physician prescribes formulary medications.
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 800-345-2460 for questions about coverage, claims and provider networks.
- View the drug formulary using the national drug list (coming soon).
- Members wanting to use Home Delivery (mail order), can call 866-216-4207 for assistance with ordering medications.
- Patients with long-term health conditions or drugs requiring special storage, must use IngenioRx for Specialty Pharmacy services. These drugs are only approved through IngenioRx and delivered via mail. View the specialty drug list to see medications on find more information on the Specialty Pharmacy Information flyer (coming soon).
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 800-345-2460 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 2019 Vision Summary for information about services, copays, and deductibles.
- Contact Anthem customer service at 800-345-2460 for questions about coverage, claims and provider networks.