Anthem PPO $500 Deductible Health Plan

Traditional coverage to help you stay healthy

The Anthem Preferred Provider Organization (PPO) $500 Deductible Health plan gives you comprehensive coverage that includes medical, prescriptionsvision, behavioral health, and organ transplant services. There are no waiting periods or limits for pre-existing conditions.

Learn more about your medical plan on this page:

Anthem

Contact Anthem by phone

  • Anthem member services: 844-736-0920
  • Anthem precertification: 866-643-7087

Access your account through the Sydney Health App or Anthem.com
You can view ID cards and claims history, find a physician, or estimate costs for care from your smartphone or tablet 24/7.

Download Sydney Health Visit Anthem.com

Plan overview

The Anthem PPO $500 Deductible Plan is a traditional medical plan. Here’s how it works:

  • Most covered services are subject to the annual deductible except for emergency room, in-network urgent care, prescriptions, and transplants.
  • After meeting your deductible, you pay 20% coinsurance for most in-network services, while the plan pays 80%. For prescriptions and emergency or urgent care, you pay flat-dollar copays.

You have access to Anthem’s extensive network: Blue Access PPO in Indiana, National PPO (BlueCard PPO) in other states, and Blue Cross Blue Shield Global Core overseas. While you can see any provider you choose, you’ll save money by staying in-network.

Monthly premiums

Your monthly premium for the HDHP depends on two main factors:

  • Your base salary: This is determined by your annual base salary at the time payroll runs each pay period.
  • Your coverage level: Choose from employee-only coverage or add your child(ren) or spouse.

Contributions are deducted before tax and you can reduce your monthly premium by $7.50 for yourself or your spouse (or $15 for both) by certifying that you and/or your spouse don’t use tobacco products, or by completing the free university-approved tobacco cessation program, each year.

2025 premiums (monthly employee contribution) based on employee salary
Coverage levelBelow $39,500$39,500 to $68,999$69,000 to $99,999$100,000 to $149,999$150,000 to $199,999$200,000 to $249,999$250,000 and above
Employee-only$170.33$205.86$266.60$318.34$372.01$427.71$485.45
Employee & child(ren)$306.58$370.57$479.89$573.02$669.62$769.87$873.83
Employee & spouse$451.37$545.56$706.52$843.63$985.82$1,133.43$1,286.51
Family$545.04$658.76$853.15$1,018.68$1,190.42$1,368.66$1,553.50

Important notes:

  • Eligible employees can choose medical coverage with or without dental coverage.
  • Faculty appointed as 10-month academic employees 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 all be deducted from the August paycheck.
  • Dually employed IU and IU Health physicians: For School of Medicine faculty who are dually employed by IU and IU Health or the Veterans Affairs (VA), the annual base salary includes both the IU base salary and IU Health compensation, as determined by the School of Medicine.

Cost-sharing basics

Here’s a quick look at what you will pay for healthcare services in 2025. To learn more about these terms, check out our health plan guide.

2025 PPO $500 Health Plan cost shares
Cost share typeIn-networkOut-of-network
Deductible

$500 per member
$1,500 family maximum

$900 per member
$2,700 family maximum

Coinsurance

20% after deductible

40% after deductible

Out-of-pocket maximum (medical)

$2,400 per member
$7,200 per family

$6,850 per member
$13,700 per family

Out-of-pocket maximum (prescriptions)

$6,800 per member
$11,200 per family

Not applicable

Preventive medical services*

$0 (plan pays 100%, not subject to deductible)

40% after deductible

*Preventive services are routine healthcare services including physical exams, well-child visits, immunizations, lab tests (e.g., Pap, PSA, cholesterol), contraceptive services (e.g., IUDs and sterilization), and other screening diagnostic services like mammograms and colonoscopies.

View preventive medical services

Vision benefit

Vision coverage is included with your IU-sponsored medical plan, but has its own benefits and network providers.

  • You get a routine eye exam every 12 months with a $10 copay.
  • Frames, lenses, and contacts are covered with specific allowances and copays when you use in-network providers.

Important note: Costs for vision services don’t count toward your medical plan’s out-of-pocket maximum.

Visit the vision page for details about your vision coverage.

Prescription benefit

In-network prescriptions have a separate out-of-pocket maximum from the medical plan: $7,050 per member/$11,700 per family.

For a brand drug with a generic version, members must pay the generic copay plus the cost difference between the brand and generic.

In-network:

Cost for in-network prescriptions
ServiceRetail (up to 30-day supply)Retail (31–90-day supply)Mail order (up to 90-day supply)
Tier 1 (Generic)$8$20$20
Tier 2 (Preferred Brand)$25$62$62
Tier 3 (Non-Preferred Brand)$45$112$112

Out-of-network:

  • Retail: 50% coinsurance (plus amounts above the network’s discounted price )
  • Mail order: Not covered.

Limits/exceptions: Out-of-pocket limit for in-network prescriptions is $6,800 for individual, or $11,200 for family. Copays do not apply toward your deductible.

Specialty drugs (up to 30-day supply) through Archimedes

  • In-network:
    • Tier 1 (generic): $20
    • Tier 2 (Preferred Brand): $62
    • Tier 3 (Non-Preferred Brand): $112
  • Out-of-network: Not covered.
  • Limits/exceptions: When using copay assistance, only the actual amount you pay counts towards your prescription out-of-pocket maximum.

Preventive medications on the No Cost Share Medication List are covered by the plan 100%.

Check drug costs for this plan

Using your benefits

Expand the accordions below for helpful information and links.

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.

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.

Your coverage travels with you. We’ve got you covered in Indiana, other states, and even overseas.

Learn more about your travel coverage

Can’t find the information you’re looking for?

Find answers to our top questions and learn how to get in touch if you can’t find what you need on our website.

Ask HR