As an eligible medical and optometry resident, you are automatically enrolled in medical, prescription, vision, and dental coverage.
Your medical plan—the Anthem IU Resident PPO Plan—is administered by Anthem. Learn more on this page:
IU resident health plans
The Anthem IU Resident PPO Plan includes dental coverage:
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.
Your medical plan: Anthem IU Resident PPO
You have a traditional preferred provider organization (PPO) health plan, which allows you to choose your doctors and hospitals from Anthem’s national and global network of providers.
The plan includes comprehensive coverage for medical, prescription, vision, mental health, and organ transplant services with no pre-existing condition limits or waiting periods.
- Most services are covered, but you’ll typically need to pay a deductible before the plan starts paying.
- You’ll pay a set amount (copay) for each prescription or urgent care visit.
- You won’t have to pay a deductible for preventive care (such as checkups and screenings), emergency room visits, in-network urgent care, prescriptions, and transplants.
- Once you’ve met your deductible, you’ll pay 20% of the cost (coinsurance) for most in-network services until you meet your out-of-pocket maximum for the year.
Cost sharing basics
The plan year begins on January 1 each year. Your deductibles and out-of-pocket amounts reset annually on this date. To learn more about these terms, check out our health plan guide.
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 benefits
Your IU Resident PPO plan includes retail and mail order prescription drug coverage through CVS Caremark and specialty drugs through Archimedes.
| Service | Retail (up to 30-day supply) | Retail or mail order (31–90-day supply) |
|---|---|---|
| Tier 1 (Generic) | $10 | $25 |
| Tier 2 (Preferred brand) | $25 | $60 |
| Tier 3 (Non-preferred brand) | $75 | $180 |
| Speciality drugs | $150 (through Archimedes) |
Out-of-network:
- Retail: 50% coinsurance (plus amounts above the network’s discounted price
- Mail order: Not covered
- Specialty: Not covered
Additional coverage details
Preventive medications on the No Cost Preventative Drug List are covered by the plan 100%.
In-network prescriptions have a separate out-of-pocket maximum from the medical plan: $7,400 per member/$13,000 per family.
If you use a manufacturer’s copay assistance program to reduce your out-of-pocket cost for a specialty drug, only the actual amount you pay will count towards your deductible and out-of-pocket maximum.
For complete details about using your prescription benefits and a list of covered medications, visit the prescription coverage page.
Vision benefits for IU residents
To help maintain your eye health, your IU medical plan includes coverage for routine eye exams, as well as discounts on glasses and contacts.
While your vision coverage is included with your medical plan, it has its own separate schedule of benefits, network providers, and costs. This means expenses for vision services do not count toward your medical plan deductible, coinsurance, or out-of-pocket maximum.
- Routine eye exams: You and each covered family member can get a routine eye exam every 12 months with a $20 copay.
- Frames, lenses, and contacts: Your plan includes coverage for frames, lenses, and contacts. Specific allowances and copays apply when you use in-network providers. Learn more about your vision benefit
Get detailed information about your coverage and in-network providers:
Additional services
Included with your coverage:
- LiveHealth Online Telehealth–Visit a board-certified physician virtually for common conditions such as rashes, allergies, pink eye, or the flu. Visits are available 24/7 and cost less than $60.
- 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. Log in to anthem.com, go to My Health Dashboard, choose Programs, and select Emotional Well-being Resources.
- Access to Marathon Health employee health centers—primary, acute (sick), and mental/behavioral health care in a convenient setting.
- Discounts – Find discounts on products and services that help promote better health, including vision and hearing services, fitness trackers, gym memberships, and more. Log in to anthem.com, choose Care, and select Discounts.
- Complimentary Clinical Review – If you are facing a complex medical condition, you may want to explore all your options. You now have a virtual complimentary clinical review from specialists at the renowned Cleveland Clinic, ranked #1 in cardiology and heart surgery and #2 among U.S. hospitals overall. This clinical review is available to you at no extra cost. To request a review, call 833-355-0454, or email anthemreferral@ccf.org.
Using your health benefits
This plan allows you to see any provider, but you’ll receive the highest level of benefits when you use in-network doctors and hospitals. This includes providers and facilities in the Anthem Blue Access PPO network in Indiana, the Anthem BlueCard PPO network in other states, and the Anthem BCBS Global Core network overseas. You can search for in-network providers on Anthem.com or the Sydney Health app.
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 plan includes up to $2,000 per year for covered medical services that are not available within 100 miles of your home. View your coverage while traveling.
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