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, prescription, vision, 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 your out-of-pocket healthcare costs.
Account Access
Resources
Plan Basics
Overview
This plan combines traditional medical coverage with a Health Savings Account (HSA). Under this plan, all covered services (except preventive services and preventive prescriptions) are subject to the annual deductible. The deductible is a dollar amount of out-of-pocket costs you must pay each year before the plan will begin paying its share of your healthcare expenses. A benefit of this plan is that you can use the tax-free funds in your HSA to cover your deductible and other qualified healthcare expenses, like coinsurance. Once the deductible has been met, most in-network services are covered with a 20% coinsurance.
This plan uses the Anthem Blue Access PPO network in Indiana, the Anthem National PPO (BlueCard PPO) network in other states, and the Anthem Blue Cross Blue Shield Global Core network overseas. You can visit any provider or facility, but you receive a higher level of benefits when you use in-network providers.
2025 Monthly Premiums
Your monthly premium is determined by your level of coverage and your base salary at the time payroll runs each pay period. Contributions are deducted before tax. You can reduce your monthly premium by $7.50 for yourself or your spouse (or $15 for both) by certifying that you do not use tobacco products, or by completing the free university-approved tobacco cessation program, each year.
2025 Premiums
Employee’s Annual Base Salary* |
|||||||
|---|---|---|---|---|---|---|---|
$68,999 |
$99,999 |
$149,999 |
$199,999 |
$249,999 |
and Above |
||
| Employee-only | $48.54 | $64.94 | $84.52 | $106.47 | $129.93 | $157.39 | $182.66 |
| Employee & child(ren) | $87.35 | $116.90 | $152.14 | $191.73 | $232.61 | $283.29 | $328.78 |
| Employee & spouse | $128.62 | $172.09 | $223.98 | $282.13 | $342.47 | $417.06 | $484.04 |
| Family | $155.31 | $207.83 | $270.46 | $340.68 | $413.55 | $503.63 | $584.49 |
*Important notes:
10-month faculty appointments who do not receive pay in the summer will have medical plan premiums caught up when they return in August. This means premiums from June, July, and August will be deducted from the August paycheck.
For School of Medicine faculty who are dually employed by IU and IU Health or the VA, the annual base salary includes both the IU and IU Health compensation, as determined by the School of Medicine.
2025 Cost Shares
Deductible
- In-Network: $2,000 employee-only / $4,000 all other coverage levels
- Out-of-Network: $4,000 employee-only / $8,000 all other coverage levels
Coinsurance
- In-Network: 20% after deductible
- Out-of-Network: 40% after deductible
Out-of-Pocket Maximum
- In-Network: $4,000 employee-only / $8,000 all other coverage levels
- Out-of-Network: $8,000 employee-only / $16,000 all other coverage levels
- In-Network: $0 (plan pays 100%, not subject to deductible)
- Out-of-Network: 40% after deductible
In- and out-of-network deductibles and out-of-pocket maximums are separate and do not accumulate toward each other.
Vision Benefit
Visit the Vision Coverage page for details about your vision coverage.
Vision coverage is included with your enrollment in an IU-sponsored medical plan, but vision services have their own schedule of benefits and network of providers. Additionally, amounts paid for vision services do not apply to your medical plan’s out-of-pocket maximum.
Prescription Benefit
Visit the Prescription Drug Coverage page for details about your coverage.
Prescription drug coverage is included with your enrollment in an IU-sponsored medical plan. Amounts paid for prescriptions apply to your medical plan deductible and out-of-pocket maximum.
CVS Caremark
Retail (up to 90-day supply)
- In-Network: 20% after deductible
- Out-of-Network: Members can submit a claim form and receipt to CVS Caremark for potential reimbursement. The amount reimbursed will be equal to the CVS Caremark price or the purchase price (less any member cost-share), whichever is lowest. Approved claims will count towards the plan’s annual in-network deductible and out-of-pocket maximum.
Mail Order (up to 90-day supply)
- In-Network: 20% after deductible
- Out-of-Network: Not covered
Preventive medications listed on the No Cost Share Medication List, including generic contraceptives, bowel preps, statins, and tobacco cessation productions, are covered at 100% by the plan.
Medications on the HDHP Preventive Rx List are covered with a 20% coinsurance and no deductible.
Check the cost of your medications on this plan.
Archimedes
Specialty Medications (up to 30-day supply)
- In-Network: 20% after deductible
- Out-of-Network: Not covered
Additional Services
The following programs are available to Anthem PPO HDHP members:
- Sydney Health App – Access your account information including claims history and ID cards, find a physician, or estimate costs for care from your smartphone or tablet 24/7.
- LiveHealth Online Telehealth – Use Anthem’s LiveHealth Online to virtually visit with an urgent, allergy, or dermatology care provider for just $59 per visit. You can also schedule virtual visits with a licensed psychologist, psychiatrist, or therapist.
- Learn to Live Emotional Well-Being – Digital support and resources to help you and your family live your happiest, healthiest lives including 1:1 coaching, support teams, webinars, and more.
- Discounts – Find discounts on products and services that help promote better health including vision and hearing services, fitness trackers, gym memberships, and more.
- Complimentary Clinical Review – If you are someone with a complex medical condition, you may want to learn as much as possible about your diagnosis, available treatment options, or a second opinion about the typical treatment plans that may be right for you. Through an exclusive offering for Anthem members, you can now receive a virtual Complimentary Clinical Review from top-ranked experts in specialties such as heart, cancer, gynecology and urology at the Cleveland Clinic. This clinical review is available to you at no extra cost.
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, usually within 7-10 business days after your enrollment, Anthem will mail physical ID cards to your home address on file.
Cards can also be accessed digitally by logging in to Anthem.com or the Sydney Health app.
If you lose your physical ID card, you can print or request a new one be mailed to you by logging in to Anthem.com 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 allows enrollment in the HSA. For more information, visit the Health Savings Account page.
What are preventive services?
Preventive services are routine healthcare services including 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 list of preventive medical services or call Anthem Customer Service at 844-736-0920 for more information. Preventive services are covered at no cost when in-network providers are used.
How do I find a health care provider?
This plan uses the Anthem Blue Access PPO network in Indiana, the Anthem National PPO (BlueCard PPO) network in other states, and the Anthem Blue Cross Blue Shield Global Core network overseas. Once enrolled in the plan, you can find in-network providers by logging in to Anthem.com or the Sydney Health app and using the Find Care tool.
What pharmacies can I use?
All outpatient prescription drugs, except specialty medications, are managed through CVS Caremark. Their retail pharmacy network includes most chain pharmacies, such as CVS, Walmart, Target, and most supermarket and club pharmacy chains. Walgreens is not an in-network pharmacy. To locate network pharmacies or check prescription coverage and costs log in to Caremark.com or the Caremark app.
Specialty medications are managed through Archimedes. These are high-cost drugs that treat complex/chronic conditions and often require special handling or administration. Most specialty medications will need to be filled by Acaria Health, the home delivery pharmacy that Archimedes partners with.
Does my health insurance include vision and vision wear coverage?
Yes. Vision and vision wear coverage is provided through Anthem Blue View Vision. This coverage is included with your medical plan enrollment, but vision services have their own schedule of benefits and network separate from medical benefits. Visit the Vision benefit page for more information.
Does my health insurance cover me while I’m traveling?
Yes, IU medical plans use the Anthem Blue Access PPO network in Indiana, the Anthem National PPO (BlueCard PPO) network in other states, and the Anthem Blue Cross Blue Shield Global Core network overseas. Visit the Travel Coverage page to learn about the travel services available to you as an IU employee, and to understand how your healthcare coverage works if you experience medical needs or emergencies while away from home.
Customer Service Contacts
Medical - Anthem
Member Services: 844-736-0920
Precertification: 866-643-7087
Blue Access PPO providers in Indiana: anthem.com
BlueCard PPO providers nationwide: provider.bcbs.com
BCBS Global Core providers internationally:
bcbsglobalcore.com or 800-810-2583
Retail/Mail Order Prescriptions - CVS Caremark
Member Services: 866-234-6952
Mail Order Services: 866-234-6952
caremark.com
Specialty Prescriptions – Archimedes
Member Services: 888-330-8248
Email:
Vision - Anthem Blue View Vision
Member Services: 866-723-0515
anthem.com
Health Savings Account – WEX
Member Services: 800-284-8412
Email:
benefit-info.com/iu (available after account is opened)
IU Human Resources
Email:
Phone: 812-856-1234