2008 Medical Care

See also:

2009 Medical Care

2008 Dental Plan

2009 Dental Plan

2008 Medical Care Plans

IU PPO $900 Deductible | IU PPO-Plus | Blue Preferred Primary POS | Definitions | Which Plan?

The university offers two types of medical plans to eligible faculty and staff:

• Two preferred provider organizations (PPOs)
• One plan managed by primary care physicians (PCPs)

To enroll in a plan, you must reside in the zip code area in which a plan is offered. Select an area from the list below to see which plans are available.

Choose the area where you live Bloomington Fort Wayne Gary Indianapolis Kokomo New Albany/Louisville Richmond South Bend ------------------------------------- Outside of Indiana

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PPO Plans

The two PPO plans are available in all areas of Indiana as well as outside the state:

• IU PPO $900 Deductible
• IU PPO-Plus (no new enrollments for 2008)

Both plans use the same Anthem Blue Access provider network for in-network medical benefits. Both plans include out-of-network benefits at a higher out-of-pocket cost to the member. Both plans offer the same retail and mail order prescription benefits through Anthem Prescription with tiered copays ($6, $17, $35 retail; $12, $36, $75 mailorder), based on the cost of the prescription. The mental health benefits are the same for both plans using the Indiana University Psychiatric Management provider network. The plans differ in their medical copays and deductibles:

IU PPO $900 Deductible (more information)
Available in all areas of Indiana and outside the state

After meeting the $900 individual deductible or the $2,700 family deductible, members pay 10 percent in-network copay and 30 percent out-of-network copay. All medical services except preventive services, prescriptions, and mental health are applied to the deductible. There is a separate Out-of-Network and In-Network deductible and copay limit.

IU PPO-Plus (more information)
Available in all areas of Indiana and outside the state

This plan has no deductible. An in-network office visit copy is $20 and most non-office services have 10 percent copay. Out-of-network services have a $300 per individual deductible, after which out-of-network services are covered at 30 percent copay. NOTE: No new enrollments will be accepted into this plan for 2008. This plan will be discontinued effective December 31, 2008. Although current participants may remain enrolled for 2008, they are encouraged to review this plan’s costs compared to the IU PPO $900 Deductible and Blue Preferred Primary POS plans which are more cost effective.

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Primary Care Physician (PCP) Managed Care Plan

The central feature of this plan is a member must select and use a PCP to provide primary care and coordinate specialist care. The plan available is:

• Blue Preferred Primary POS

Blue Preferred Primary POS (more information)
Available in most areas of Indiana, as well as outside the state.

This plan has $20 office visit, $250 inpatient, and $75 outpatient copays. Each family member selects a PCP and uses network providers for in-network services. Out-of-network services are covered at 30 percent copay after meeting an out-of-network $500 individual deductible. Managed prescription benefits are provided with tiered copays based on generic or formulary brand designations. (Formulary or select brands are those drugs designated by the plan for lower copays based on the efficacy and cost-effectiveness of the drug.) Mental health benefits are provided through the Anthem Behavioral Health network. This plan has a $5 million dollar lifetime limit.

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For all plans, to access information on background and licensing of individual doctors, nurses, chiropractors and pharmacists, call Indiana Health Professions Bureau (toll free) 888-333-7515.

Benefit plan information on these web pages is in a summary format and is not intended to replace actual plan documents. Indiana University reserves the right to amend or terminate all or any part of any benefit plan.