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IU HEALTH MEDICAL PLAN OPTIONS



Beginning in 2023, IU Health team members have three medical plan options to
choose from, including: a Health Savings Account (HSA), a Health Reimbursement
Arrangement (HRA) or an IU Health Premier Plan.

Team members who have an HSA or an HRA plan may choose their provider and
facilities with the percentage of care covered by the plan based on where the
care is received (IU Health/Community Health Network, Aetna ASA). Those with the
IU Health Premier Plan, should choose an IU Health provider and its facilities.
For the HSA and HRA, the highest levels of coverage are offered when IU Health
or Community Health Network providers and facilities are used. For IU Health
Premier, the only level of coverage is at IU Health providers and facilities
with few exceptions.





Prescription Information

Medical Plan Information

Vision Information

Provider Directory

MEMBER LOGIN





Member Login


PRESCRIPTION INFORMATION



2023 Prescription Information

Customer Service
844.432.0704

Monday through Friday: 8:00 a.m. to 6:00 p.m. ET



FORMULARIES

 * 2023 Preferred Generic List
 * 2023 Pharmacy Formulary
 * 2023 Drugs Requiring Prior Authorization and Step Therapy

PHARMACIES

 * IU Health Affiliated Retail Pharmacies - CY2023 Pharmacy List
 * IU Health Plans Pharmacy Directory
 * Copay Card Assistance Program

PHARMACY PLAN INFORMATION

 * 2023 Preventive List
 * $0 Diabetic Testing Supply Program
 * $0 Diabetic Medications
 * Rx Reimbursement Form
 * IU Health Pharmacy Mail Order and Specialty Pharmacy Enrollment Form
 * Premier Medical Plan 2023 Medical and Pharmacy Benefits


MEDICAL PLAN INFORMATION



Medical Plan Information
IU Health Plans
Member Services: 866-895-5975

Hours: 7:00 a.m. to 7:00 p.m. ET

 

Click here to view the 2023 Summary Plan Document (SPD) for the IU Health
Medical Plans

Click here to view the 2023 Medical and Pharmacy Benefits for the IU Health
Premier Medical Plan

 

IU Health Plans COBRA & Flexible Spending Account (FSA) Plans

IU Health COBRA website

     Phone: 877.272.8880  select option 2

Flexible Spending Account

     + IU Health FSA Website

     Phone: 877.272.8880 select option 1

 

Employee Direct Deposit Form

Additional Debit Card Request Form

IUH Online Flex Registration



GENERAL INFORMATION

 * Health Savings Account Qualified Expenses
 * HSA Optum Bank
 * TruHearing
 * MinuteClinic at CVS

MEMBER SUPPORT

 * Medicare Part D Credible Coverage Disclosure Notice
 * Children's Health Insurance Program (CHIP) Notice
 * SAR Notice
 * Medical Claim Reimbursement Form
 * Preventive Services
 * Services Requiring Medical Prior Authorization
 * Prior Authorization Form
 * IU Health Plans Vision (powered by Eyemed) Benefits Summary
 * IU Health Lab Service Center Hours and Locations
 * Healthy Results Wellness Portal
 * Transition of Care Form
 * Transition of Care FAQ
 * Coordination of Benefits Form
 * Infertility Benefits Flyer

SUMMARY OF BENEFITS AND COVERAGE

 * 2023 SBC - IU Health Northern Region/Paoli-SIP/OOA HRA Medical Plan
 * 2023 SBC - IU Health HRA Medical Plan
 * 2023 SBC - IU Health Northern Region/Paoli-SIP/OOA HSA Medical Plan
 * 2023 SBC - IU Health HSA Medical Plan
 * 2023 SBC - IU Health Premier Medical Plan – All Regions
 * 2024 SBC - IU Health Northern Region/Paoli-SIP/OOA HRA Medical Plan
 * 2024 SBC - IU Health HRA Medical Plan
 * 2024 SBC - IU Health Northern Region/Paoli-SIP/OOA HSA Medical Plan
 * 2024 SBC - IU Health HSA Medical Plan
 * 2024 SBC - IU Health Premier Medical Plan – All Regions

LEGAL FORMS

 * Protected Information Release Form
 * Appointment of Health Care Representative Form
 * Life Prolonging Procedures Declaration Form
 * Living Will Declaration Form
 * IU Health Notice of Privacy Practices


VISION INFORMATION



VISION BENEFIT

 * 2023 Employee Vision Plan
 * 2021 Employee Medical Exam Only Plan
 * 2020 Vision EOC




PROVIDER INFORMATION



PROVIDER DIRECTORIES

 * IU Health Network Online Directory
 * Aetna ASA Network Online Directory