Home > Benefits > 2017 Health Care Plans > Anthem PPO HDHP

2017 Anthem PPO High Deductible Health Plan (Anthem PPO HDHP)

The Anthem Preferred Provider Organization High Deductible Health Plan (Anthem PPO 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 Anthem PPO HDHP, you are also eligible to elect a Health Savings Account (HSA), a special tax-advantaged bank account to help cover out-of-pocket costs.

Top FAQs Resources & Forms Customer Service View My Benefits

Plan Basics

Overview

This plan combines traditional medical coverage with a Health Savings Account (HSA), which gives you greater flexibility and discretion over how you use your health care dollars. With this plan, the annual deductible must be met before plan benefits are paid for services other than in-network preventive care, which is covered at 100%. You may visit any doctor or hospital, but you receive a higher level of benefits when you use Blue Access PPO providers.

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 medical services and prescriptions except wellness/preventive. When one or more family members are covered, the family deductible must be met before services are covered for any member.

In-Network: $1,300 for employee-only coverage/$2,600 all other coverage levels
Out-of-Network: $2,600 for employee-only coverage/$5,200 all other coverage levels

Network and Non-Network deductibles are separate and do not accumulate toward each other.

Co-Insurance

Co-insurance is the percent of a covered health care 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-Network: 40% after deductible

Out-of-Pocket Maximum

The out-of-pocket maximum is the most you will have to pay during a policy period for health care services. Once you have reached your out-of-pocket maximum, the plan begins to pay 100% of the allowed amount for covered services. All coinsurances and deductibles apply towards this maximum.

In-Network: $2,600 for employee-only coverage/$5,200 all other coverage levels
Out-of-Network: $5,200 for employee-only coverage/$10,400 all other coverage levels

Network and Non-Network out-of-pocket maximums are separate and do not accumulate toward each other.

Prescription Benefit

Retail (up to 30-day supply)
In-Network: 20% after deductible
Out-of-Network: 40% after deductible

Mail Order (up to 90-day supply) and Specialty
In-Network: 20% after deductible
Out-of-Network: Not covered

There is no coinsurance or deductible on most contraceptives, and no deductible on preventive prescriptions.

View detailed plan information about the Anthem PPO HDHP (PDF)

Top Frequently Asked Questions

Below are answers to the most frequently asked questions regarding the Anthem PPO HDHP.  

Where can I find my Anthem ID Card?

Once your enrollment in the plan has been processed, Anthem will mail you an official membership packet and ID card(s).

If you need proof of coverage before your permanent card arrives, you can print a temporary ID card (PDF).

If you’ve lost your permanent ID card, you can request a new one by logging on to Anthem and choosing the “Request an ID card” link, or by calling Anthem Customer Service at 844-736-0920.

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 the Summary of Preventive Services (PDF) or call Anthem Customer Service for more information.

How do I find a health care provider?

The plan uses Anthem Blue Access in Indiana and Blue Cross & Blue Shield (“Blue Card” providers) in other states and overseas. Once enrolled in the plan, you can use the Castlight Health tool or logon to Anthem to find in-network providers.

What pharmacies can I use?

Express Scripts pharmacy network includes most retail chain pharmacies, such as CVS, Walmart, Target, and most supermarket and club pharmacy chains. To locate network pharmacies, check prescription coverage and costs visit the Express Scripts website.

Does the plan include Vision Wear coverage?

Yes. Vision Wear coverage is provided through Anthem Blue View 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.

More Anthem HDHP FAQs

Customer Service Contacts

Medical - Anthem
Member Services: 844-736-0920
www.anthem.com (select Blue Access PPO)
BlueCard network providers outside of Indiana:
800-810-2583 or www.bcbs.com

Prescription - Express Scripts
Member Services: 800-988-1794
Mail Order Services: 800-988-1794
www.expressscripts.com/iu

Vision - Anthem Blue View Vision
Member Services: 866-723-0515
www.anthem.com

Health Savings Account – The Nyhart Company
Member Services: 800-284-8412
Email: 
iu.nyhart.com (available after account is opened)

IU – IU Human Resources 
Benefit Questions: 812-856-1234
Benefit Email:

Resources & Forms View My Benefits