Medical Plans Overview

At Indiana University, we offer a range of health care plans designed to meet the diverse needs of our employees. Whether you're looking for a plan with a health savings account (HSA) option or traditional coverage, we've got you covered. Here's an overview of our medical plan offerings:

High Deductible Health Plan (HDHP)

Anthem PPO HDHP: This plan offers higher deductibles, but substantially lower premiums than the traditional plan option. This plan includes eligibility for the health savings account (HSA) option, allowing you and IU to make tax-free contributions towards your eligible medical expenses. With comprehensive coverage including a national and global network of providers, this plan features deductibles and out-of-pocket maximums that are distinct from traditional plans. Key plan features include:

In-network deductible: $2,000 (employee-only) / $4,000 (other coverage levels).
In-network out-of-pocket maximum: $4,000 (employee-only) / $8,000 (other coverage levels).
20% coinsurance after the deductible is met.
Preventive services and certain preventive prescriptions covered at 100%.

Enrollment in the HDHP allows you to also enroll in the HSA, which includes a sizable contribution from the university. You must meet the additional IRS eligibility qualifications to enroll in the HSA.

Traditional Deductible Plan

Anthem PPO $500 Deductible Plan: This plan offers a lower deductible, but significantly higher premiums than the HDHP option. The plan includes flat-dollar copays for certain services and prescriptions based on a tiered drug list. With comprehensive coverage including a national and global network of providers, this plan features deductibles and out-of-pocket maximums that are distinct from the HDHP option. Key plan features include:

In-network deductible: $500 (individual) / $1,500 (family maximum).
In-network out-of-pocket maximum: $2,400 (individual) / $7,200 (family maximum).
Flat-dollar copays for emergencies, in-network urgent care, and prescriptions.
Separate out-of-pocket maximum for in-network prescriptions.

Employees enrolled in this plan are not eligible for the HSA.

Comparing IU’s Medical Plan Options

Download the Medical Plan Comparison Chart

Preventive Care Coverage

All IU health plans cover preventive care at 100%, aligning with federal guidelines. Preventive care services may include (but are not limited to):

Routine and periodic wellness exams.
Routine immunizations for adults and children.
Screening tests such as colonoscopies, mammograms, bone density testing, cancer screenings, and cholesterol labs.
Women’s health services including oral contraceptives, IUDs, hormone implants, injections, and sterilization.
Pediatric fluoride, low dose aspirin, and tobacco cessation products (up to certain limits).

Some services may have age or other restrictions to be considered preventive. View the full list of preventive medical services. Call Anthem customer service at the number on your ID card for additional information about these services.

Plan Similarities

No pre-existing condition limits or waiting periods.
Both plans offer a travel benefit for covered medical services that aren't available within 100 miles of the member’s home.
Both plans cover in-network preventive care at 100%.
Services are comprehensive and include medical, prescription, behavioral health, transplants, durable medical equipment, home health care, skilled nursing, therapy, and chiropractic services.
Both plans have a nationwide and overseas network of providers and offer out-of-network benefits.
Both plans include a vision and vision wear benefit.
Both plans have annual out-of-pocket maximums to protect you from high costs.
No lifetime maximum benefit on medical services.

Plan Differences

Premiums. The higher the deductible, the lower the premiums.
The deductible and prescription benefits are structured differently.
Deductibles, coinsurance, and copays vary in structure and amounts.
Health Savings Account (HSA). A unique tax-advantaged health savings account (HSA) is available to those enrolled in an HDHP.

Understanding the specifics of each plan, from deductibles and out-of-pocket maximums to preventive care coverage, can help you choose the best option for you and your family's health care needs. For more detailed information, visit the dedicated pages for the Anthem PPO HDHP and the Anthem PPO $500 Deductible Plan.