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Anthem Blue Cross and Blue Shield of Indiana SmartSense Standard Rx – Indiana Health Insurance Plan

A detailed comparison of the Anthem Blue Cross and Blue Shield of Indiana SmartSense 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 $35 copay for the first three visits per member per year. N/A
OfficeVisit $35 copay for the first three visits per member per year. 4+ visits and Other Services: Member pays 30% after deductible. Member pays 50% after deductible
Deductible false Individual: $500, Family: $1,000 Individual: $500, Family: $1,000
Coinsurance 30% 50%
Coinsurance Limit
Out-of-Pocket Maximum N/A N/A
Lifetime Maximum Unlimited Unlimited
Prescription Drugs
  • Prescription drugs for Mental Health & Substance Abuse are not covered.
  • FOR DRUGS ON FORMULARY: Greater of $15 copay or 40% Coinsurance FOR DRUGS NOT ON FORMULARY:
  • Member is responsible for entire cost after applied Anthem negotiated dis
    		•
  • Prescription drugs for Mental Health & Substance Abuse are not covered.
  • FOR DRUGS ON FORMULARY: Greater of $15 copay or 40% Coinsurance in addition Member is responsible for difference between Anthem's allowable charge and actual cost of drug
    • Emergency Room Member pays 30% after deductible Member pays 30% 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 well-child care, immunizations, PSA screenings, Pap tests, mammograms etc.
  • No deductible, copay, or coinsurance.
    		•
  • Includes all nationally recommended preventive services including well-child care, immunizations, PSA screenings, Pap tests, mammograms etc.
  • Member pays 50% after deductible
    		•
    Child Preventative Care
  • Includes all nationally recommended preventive services including well-child care, immunizations, PSA screenings, Pap tests, mammograms etc.
  • No deductible, copay, or coinsurance.
    		•
  • Includes all nationally recommended preventive services including well-child care, immunizations, PSA screenings, Pap tests, mammograms etc.
  • Member pays 50% after deductible
    		•
    Lab / X-Ray Member pays 30% after deductible Member pays 50% after deductible
    Maternity Not Covered, except covered for complications of pregnancy only. Not Covered, except covered for complications of pregnancy only.
    Physical Therapy Member pays 30% after deductible (PT/Spinal Manipulation Therapy - 20 visits combined) Member pays 50% after deductible (PT/Spinal Manipulation Therapy - 20 visits combined)
    Home Health Care Member pays 30% after deductible (Home Health Care Limited to 60 visits. Infusion Therapy does not count toward the limit.) Member pays 50% after deductible (Home Health Care Limited to 60 visits. Infusion Therapy does not count toward the limit.)
    Mental Health
    Hospital Care Member pays 30% after deductible Member pays 50% after deductible
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