IU Health High Deductible Health Plan
The IU Health Plans High Deductible Health Plan (IU Health 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 IU Health 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 costs.
Resources
Account Access
Plan Basics
Overview
This plan combines traditional medical coverage with a Health Savings Account (HSA). Under this plan, all covered services (except preventive services/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. The nice thing about this plan is that you can pay for that deductible (and other qualified healthcare expenses like coinsurance) using the tax-free funds in your HSA. Once the deductible has been met, most in-network services are covered with a 20% coinsurance.
The IU Health HDHP plan exclusively uses the IU Health provider network. This plan does not offer out-of-network benefits except in the case of an emergency, urgent care when more than 50 miles from home, or for the dependent of an Indiana-resident employee when the dependent lives out of the state of Indiana for reasons other than medical treatment.
2022 Monthly Premiums
Your monthly premium is determined by your level of coverage and your base salary. Contributions are deducted before tax. You can reduce your monthly premium by $25 for yourself or your spouse (or $50 for both) by certifying that you do not tobacco products each year.
Employee’s Annual Base Salary* |
|||||||
$59K |
$99K |
$149K |
$199K |
$249K |
and Above |
||
| Employee-only | $38.11 | $51.09 | $66.81 | $84.29 | $102.45 | $124.83 | $144.95 |
| Employee & child(ren) | $68.61 | $91.98 | $120.29 | $151.72 | $184.39 | $224.68 | $260.91 |
| Employee & spouse | $101.00 | $135.41 | $177.08 | $223.37 | $271.47 | $330.79 | $384.12 |
| Family | $121.96 | $163.51 | $213.83 | $269.73 | $327.80 | $399.43 | $463.85 |
* The employee’s salary band is determined by the annual base salary at the time payroll runs each month. For School of Medicine full-time faculty who receive a portion of their pay from an IU Health or VA paycheck, annual base salary includes both IU base salary and certain IU Health fixed and/or variable compensation, as determined by the School of Medicine.
K=1,000
Employee contributions are deducted before taxes.
Subtract $25 per month for an employee or spouse ($50 for both) who do not use tobacco and complete a tobacco-free affidavit.
Annual Deductible
The deductible is the amount you must pay out-of-pocket before the plan will begin to pay benefits. The deductible applies to all covered services except preventive services/prescriptions. When one or more family members are covered, the family deductible must be met before services are covered for any member.
In-Network: $2,700 for employee-only coverage / $5,400 all other coverage levels
Coinsurance
Coinsurance is the percent of a covered healthcare service you pay after you have paid your deductible. For example, if your coinsurance is 20%, you pay 20% of the cost and the plan will pay the other 80%.
In-Network: 20% after deductible
Out-of-Pocket Maximum
The out-of-pocket maximum is the most you’ll have to pay for covered services in a plan year. After you spend this amount on deductibles, copays, and coinsurance, the plan begins to pay 100% of the allowed amount for covered services.
In-Network: $3,400 for employee-only coverage / $6,800 all other coverage levels
Prescription Benefit
Retail (up to 30-day supply)
In-Network: 20% after deductible
Out-of-Network: No Coverage
Retail at CVS Pharmacy (up to 90-day supply)
In-Network: 20% after deductible
Mail Order (up to 90-day supply) and Specialty (up to 30-day supply)
In-Network: 20% after deductible
Out-of-Network: No Coverage
There is no coinsurance or deductible on most contraceptives, and no deductible on preventive prescriptions.
Additional Services
The following program is available to IU Health HDHP members:
- IU Health Virtual Visits 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.
- MyStrength 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.
Top Frequently Asked Questions
Below are answers to the most frequently asked questions regarding the IU Health HDHP.
Where can I find my IU Health ID Card?
Once your enrollment in the plan has been processed, IU Health will mail you an official membership packet and ID card(s). If you’ve lost your permanent ID card, you can request a new one by calling IU Health Member Services at (866) 895-5975.
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 or the IU Health HDHP allows enrollment in the HSA. For more information, visit the Health Savings Account page.
What are Preventive Services?
Preventive services are covered at no cost when network providers are used. Preventive services include 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 Preventive Medical Services or call IU Health Customer Service at (866) 895-5975 for more information.
How do I find a health care provider?
The IU Health HDHP plan exclusively uses the IU Health provider network. Visit the IU Health site to search for an in-network provider by location.
What pharmacies can I use?
CVS Caremark pharmacy network includes most retail chain pharmacies, such as CVS, Walmart, Target, and most supermarket and club pharmacy chains. To locate network pharmacies or check prescription coverage and costs, visit the Caremark.com or the Caremark app.
Does the plan include Vision Wear coverage?
Yes. Vision Wear coverage is provided through EyeMed Vision. Coverage is included in your enrollment in the medical plan, but vision services have their own schedule of benefits and network providers separate from medical benefits. Visit the Vision Wear benefit page for more information.
What is Transition of Care? What do I do if I am in the middle of a medical treatment when I enroll?
Transition of care coverage is medical coverage that may be available to you and/or your dependents if you are a new member of IU Health Plans or your doctor leaves an IU Health Plans network. Transition of care coverage allows you to continue to receive treatment for covered services with a doctor and/or facility that does not participate in an IU Health Plan’s network. This coverage is for a defined period of time until the safe transfer of care to an in-network doctor and/or facility can be arranged. Download the Transition of Care FAQ or Transition of Care form for more information.
Customer Service Contacts
Medical – IU Health Plans
Member Services: 866-895-5975
www.iuhealthplans.org
Prescription - CVS Caremark
Member Services: 866-234-6952
Mail Order Services: 866-234-6952
www.caremark.com
Vision - EyeMed Vision
Member Services: 866-804-0982
www.eyemed.com
Health Savings Account – The Nyhart Company
Member Services: 800-284-8412
Email:
iu.nyhart.com (available after account is opened)
IU Human Resources
Email:
Phone: 812-856-1234