Anthem IU Resident Medical Plan
The Anthem IU Resident PPO medical plan is administered by Anthem and is available to all eligible Medical & Optometry residents. 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.
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Resources
Plan Basics
Overview
This is a traditional PPO medical plan. Under this plan, all covered services (except preventive, emergency room, in-network urgent care, prescriptions, and transplants) are subject to the annual deductible. You pay flat-dollar copays for prescriptions and emergency/urgent care, with most other in-network services covered with a 20% coinsurance after you meet your deductible.
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.
This plan includes a travel benefit of up to $2,000 annually for covered medical services that are not available within 100 miles of the member’s home.
Monthly Premiums
Premiums for eligible residents and qualifying dependents are fully paid by the affiliated hospitals through the School of Medicine Office of Graduate Medical Education.
Cost Shares
The plan year begins each January 1. Deductibles and out-of-pocket amounts reset annually this date.
Deductible
- In-Network: $450 person / $1,350 family
- Out-of-Network: $1,800 person / $5,400 family
Coinsurance
- In-Network: 20% after deductible
- Out-of-Network: 40% after deductible
Out-of-Pocket Maximum
- In-Network: $1,800 person / $5,400 family
- Out-of-Network: $7,200 person / $14,400 family
Prescription Benefit
Visit the CVS Caremark page for details about your prescription coverage.
Retail (up to 30-day supply)
Tier 1 - $10 / Tier 2 - $25 / Tier 3 - $75
Non-Covered Drugs (with Network Discount) – Member pays 100%
Retail at CVS Pharmacy (up to 90-day supply)
Tier 1 - $25 / Tier 2 - $60 / Tier 3 - $180
Non-Covered Drugs (with Network Discount) – Member pays 100%
Mail Order (up to 90-day supply)
Tier 1 - $25 / Tier 2 - $60 / Tier 3 - $180
Non-Covered Drugs (with Network Discount) – Member pays 100%
Specialty (up to 30-day Mail Order supply)
Tier 4 - $150
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 deductible, coinsurance, or 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, see the 2024 Vision Summary for details.
Additional Services
The following programs are available to Anthem IU Resident 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.
- AllClear ID Protection – Identity repair, credit monitoring, and identity monitoring from AllClear ID is provided to all Anthem members at no cost. Download the program flyer to learn more.
- 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.
Frequently Asked Questions
Below are answers to the most frequently asked questions regarding the Anthem IU Resident 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 2024 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