Student Academic Appointees/Appointed PostDoc Fellows
Medical
The Anthem IU SAA PPO plan is administered by Anthem and is available to all eligible appointees, regardless of area of residence. The plan includes comprehensive coverage for medical, prescription, vision, behavioral health, and organ transplant services with no pre-existing condition limits or waiting periods. When network providers are used, participants receive full benefits. Partial benefits are received from non-network providers, except in the case of an emergency.
Overview
This is a traditional PPO medical plan with no in-network deductible. You pay flat-dollar copays for some services such as office visits, emergency/urgent care, and prescriptions, with other in-network services 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. Find a network provider.
Plan Highlights
Highlights of the plan include:
- No annual deductible
- Office/specialist visit copays: $25/$35
- Urgent care/emergency room copays: $50/$150
- In-network preventive services covered at 100%
- Most other services covered with 20% coinsurance
- Vision and vision wear coverage through Anthem Blue View Vision
- Prescription coverage through CVS Caremark
Review the plan summaries for details:
Publications
Forms
Resources
Monthly Premiums
Premiums for qualifying Appointees are fully paid by the University.
| Appointee | |||
|---|---|---|---|
| ^The Fall premium is for August 1 – December 31. The Spring premium is for January 1 – July 31. The rate includes both medical and dental coverage. | |||
If you choose to enroll your spouse or children, you are responsible for the full cost of their monthly premiums.
Premium |
Premium |
Premium |
|
|---|---|---|---|
| 2023 | |||
| Spouse* | |||
| Child(ren)* | |||
|
Review the Eligibility and Enrollment Guidelines to verify your dependent’s eligibility for coverage. Dependents can only be covered for the same period of coverage as the appointee. Eligible dependents must be enrolled by submitting the following items to IU Human Resources by the enrollment deadline:
Dependent Enrollment Deadlines:
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2023 Cost Shares
The plan year is January 1 – December 31 each year. Deductibles and out-of-pocket amounts reset annually on January 1.
Deductible
- In-Network: $0 person / $0 family
- Out-of-Network: $500 person / $1,000 family
Coinsurance
- In-Network: 20% after deductible
- Out-of-Network: 40% after deductible
Out-of-Pocket Maximum
- In-Network: $2,000 person / $4,000 family
- Out-of-Network: $4,000 person / $8,000 family
Prescription Benefit
Visit the CVS Caremark page for details about your prescription coverage.
Retail (up to 30-day supply)
- $8 generic
- $25 preferred brands
- $45 non-preferred brands
Retail & Mail Order (up to 90-day supply)
Specialty (up to 30-day supply)
- $20 generic
- $62 preferred brands
- $112 non-preferred brand
Vision Benefit
Vision coverage is included with your enrollment in an IU-sponsored medical plan, but vision services have their own schedule of benefits and network providers separate from your medical plan. Additionally, amounts paid for vision services do not apply to your medical plan’s out-of-pocket maximum. Benefits include:
- A routine eye exam for each covered member every 12 months with a $20 copay.
- Frames, lenses, and contacts are covered with specific allowances and copays for in-network providers.
Additional Services
he following programs are available to Anthem IU SAA PPO 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 – Visit with a board-certified physician virtually for common conditions such as rashes, allergies, pink eye, or the flu. Visits are available 24/7 and cost just $59.
Frequently Asked Questions
Below are answers to the most frequently asked questions regarding the Anthem IU SAA PPO Plan.
Where can I find my Anthem ID Card?
Once your enrollment in the plan has been processed, Anthem will mail a physical ID card to your home address on file. Cards are issued in the subscriber’s name only, and should be used by all covered family members.
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 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 a Doctor tool.
What pharmacies can I use?
The CVS Caremark pharmacy network includes most retail 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.
Does the plan 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. Review the 2023 Vision Plan Summary for more information.
Customer Service Contacts
Medical - Anthem
Member Services: 844-736-0920
Precertification: 866-643-7087
Blue Access PPO providers in Indiana: www.anthem.com
BlueCard PPO providers nationwide: provider.bcbs.com
BCBS Global Core providers internationally: bcbsglobalcore.com or 800-810-2583
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
IU Human Resources
Email:
Phone: 812-856-1234