• The standard plan year begins August 1 and ends July 31 the following year

• The Plan includes comprehensive medical, prescription, vision, and dental coverage for one premium

• The medical plan uses the Anthem Blue Access PPO network with access to providers throughout Indiana, nationwide and overseas

• Deductibles and out-of-pocket amounts restart annually on August 1

• Annual deductible is $350 per member / $1,050 per family for in-network coverage

• Out-of-pocket maximum is $5,000 per member / $10,000 per family for in-network coverage

• In-network preventive care is covered by the plan at 100%

• IU Student Health Center office visit copay is $15

• Primary Care office visit copay is $25; Specialist office visit copay is $35

• Urgent Care copay is $50; Emergency Room copay is $100

• Most other services are covered with 20% coinsurance after deductible

• Medical coverage includes therapy services such as chiropractic care, physical therapy, behavioral health, mental health, and substance use disorder services; See student brochure or plan booklet for more information

• Vision care coverage through Anthem Blue View Vision, including an annual eye exam with a $20 copay and discounts for vision wear

• Dental care coverage through Anthem Blue Cross and Blue Shield Dental Complete, includes diagnostic and preventive services covered at 100% when using in-network providers

• More detailed benefit information is located on the left side of this page

• Sydney Health app to access your Anthem ID card, find a provider, see claims, and more

• Your medical coverage follows you wherever you go, including nationwide and overseas. As an Anthem member, you have access to care across the country through the BlueCard PPO program, and outside the U.S. through the BCBS Global Core program. Visit the Student Travel Coverage page in the left-hand menu to learn more, including how to find doctors and how to access emergency or non-emergency healthcare while traveling.

• Your health plan includes access to emergency travel assistance through Academic Emergency Services (AES). With AES you have access to 24/7 support if you experience an emergency while traveling over 100 miles from home or outside your country. Services include emergency medical evacuation and repatriation, pre-travel and safety assistance, and an accidental death & dismemberment (AD&D) benefit. Learn more by reviewing Plan Provisions or the AES Flyer & Wallet Card in the left hand menu. AES is available 24/7 by calling 1-855-873-3555 (within the U.S.) or +1-610-263-4660 (outside the U.S.).

• 24/7 Nurseline for guidance on non-emergency health questions and concerns (call 844-545-1429)

• 24/7 virtual access to doctors through LiveHealth Online

• 24/7 access to confidential counseling and support through the Student Assistance Program (SAP)

Participation in this plan is mandatory for domestic graduate students who are currently taking classes in the following programs:

• IU School of Medicine (IUSM),
• IU School of Dentistry (IUSD),
• IU School of Health and Human Sciences (SHHS),
• IU School of Optometry (IUSO), and
• IU Department of Speech/Language Pathology Master’s and Doctor of Audiology (SLHS)

As an eligible student you are automatically enrolled in the plan each semester and billed for the premium through your bursar account. Participation is mandatory unless proof of comparable coverage and a waiver form are submitted and approved by the deadline (see Waiver Deadline and Waiving Coverage section below).

As an eligible student, you have the option to insure your spouse and unmarried children under the age of 26 for an additional cost. Coverage is only available to your dependents if and when you are insured under the plan. Complete the dependent enrollment form in the left-hand menu to cover your dependent(s) on the plan. Your application and premium payment must be completed by the deadlines found in the chart below. Dependent premiums can be paid in full at the time of enrollment or by monthly installments; however, they cannot be charged to your bursar account. Once enrolled, no portion of the premiums are eligible to be refunded.

If the enrollment deadline has passed, you cannot enroll your dependent(s) until the next coverage period, unless you or your dependent have experienced an IRS-qualifying life event (i.e., marriage, birth of a child, loss of prior coverage). If your dependent experiences a qualifying life event you will need to submit a qualifying event enrollment form in the left-hand menu and submit supporting documentation within 30 days of the event.

If you have comparable health insurance coverage that meets the following requirements, you may be eligible to waive enrollment in the Professional Student Health Insurance Plan.

• Your plan must be active at the start of the semester/term.
• Your plan must be filed and approved in the U.S. and compliant with the Affordable Care Act (ACA).¹
• Your plan must provide comprehensive non-emergency benefits including primary care doctors, specialists, hospitals, labs, pharmacies, mental health and substance abuse providers in the geographical area surrounding your campus.²
• Your plan must have an annual deductible of $9,100 (individual) / $18,200 (family) or less.

By waiving this plan you will be certifying that the coverage under your health plan is comparable to coverage under the Student Health Insurance Plan, and you understand that you are responsible for your medical expenses. You will also certify that your insurance coverage will remain in effect, providing coverage in the geographic area surrounding the Indiana University campus during the 2024-2025 academic year. The submission of your waiver form, including all information submitted, constitutes truthful and accurate statements.

Further, you agree that if you involuntarily lose coverage prior to the end of the academic year, you will contact the IU Student Insurance office at studenhc@iu.edu. You must complete an application form and provide supporting documentation of your loss of coverage within 30 days of the date your coverage ends. Your bursar account will then be charged a prorated premium amount based on the number of days of coverage.

Once submitted, your waiver request will be reviewed and you will then receive an email from UHP within 3 business days with your approval, denial or request for further documentation.

• If approved, it may take up to 10 business days to post the premium reversal to your bursar account. Your approved waiver is effective for the entire academic year. You may not enroll onto the Professional Insurance plan during the year unless you experience an IRS-qualifying life event.
• If your waiver is denied, your IU Professional Insurance plan enrollment will remain in effect for the academic year and the full premium will remain on your bursar account. If you feel your waiver was unfairly denied, you may submit an appeal to studenhc@iu.edu within 30 days of your denial notice for further consideration.
• If additional information is needed in order for your waiver request to be processed, please follow the instructions provided in the email sent to you.

A new waiver is required to be submitted each academic year.

After enrollment, you’ll receive an email from Anthem Student Advantage when your digital ID card is ready to download. You can access your ID card by downloading the Sydney Health app or visiting Anthem.com. You can then email or fax it from your smartphone or computer or request a hard copy ID card be mailed to your address on file.

IU has partnered with University Health Plans to administer the plan and help with student and dependent waiver, enrollment and eligibility-related questions. University Health Plans can be reached at 833-251-1717 or info@univhealthplans.com.

For benefit or claim-related questions, Anthem can be reached at 844-412-0752.

To enroll onto the IU Professional Student Insurance Plan mid-year, contact the IU Student Insurance office at 812-856-4650 or studenhc@iu.edu.