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Anthem Blue Cross and Blue Shield of Indiana Premier Plus 80% Standard Rx – Indiana Health Insurance Plan

A detailed comparison of the Anthem Blue Cross and Blue Shield of Indiana Premier Plus 80% Standard Rx health insurance plan as offered in Indiana is listed below for both Network and Non-Network coverage. This is a review of the coverage for this specific Anthem Blue Cross and Blue Shield of Indiana plan. However, GoHealthInsurance offers a large variety of health insurance options to fit your needs. If you wish, get a new Anthem Blue Cross and Blue Shield of Indiana health insurance quote for Indiana now or view all of our Anthem Blue Cross and Blue Shield of Indiana health insurance quotes.

  Network Non-Network
Copay $30 PCP / $40 Specialist N/A
OfficeVisit
  • $30 PCP / $40 Specialist
  • Other Services: 20% after deductible
    		•  40% after deductible
    Deductible false Individual: $1,000, Family: $2,000 Individual: $1,000, Family: $2,000
    Coinsurance 20% 40%
    Coinsurance Limit
    Out-of-Pocket Maximum N/A N/A
    Lifetime Maximum Unlimited Unlimited
    Prescription Drugs Retail (30 day supply) -
    • Tier 1 - $15 Copay
    • Tier 2, 3, 4: Member pays 40% coinsurance with $30 minimum copay. Separate $250 deductible per member per year, $4,000 OOP max. per member per year.
    Mail Order (90 day supply) -
    • Ti
  • Retail: 50% coinsurance with $60 minimum. Separate $250 deductible per member per year on Tiers 2, 3 and 4. Member is responsible for the difference between Anthem allowable amount and actual charge in addition to cost share.
  • Specialty Prescript
    		•
    Emergency Room 20% after deductible 20% after deductible (Member is responsible for charged amount that exceeds Anthem's maximum allowable amount.)
    Adult Preventative Care Includes all nationally recommended preventive services including immunizations, PSA screenings, Pap tests, mammograms etc.: No deductible, copay, or coinsurance Includes all nationally recommended preventive services including immunizations, PSA screenings, Pap tests, mammograms etc.: 40% after deductible
    Child Preventative Care Includes all nationally recommended preventive services including well-child care, immunizations, etc.: No deductible, copay, or coinsurance Includes all nationally recommended preventive services including well-child care, immunizations, etc.: 40% after deductible
    Lab / X-Ray 20% after deductible 40% after deductible
    Maternity Not Covered, except covered for complications of pregnancy only. Not Covered, except covered for complications of pregnancy only.
    Physical Therapy 20% after deductible (PT/Spinal Manipulation Therapy - 20 visits combined) 40% after deductible (PT/Spinal Manipulation Therapy - 20 visits combined)
    Home Health Care 20% after deductible 40% after deductible (Home Health Care Limited to 60 visits. Infusion Therapy does not count toward the limit.)
    Mental Health 20% after deductible 40% after deductible
    Hospital Care 20% after deductible 40% after deductible
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