COVID-19 Coverage and Billing - Public Health Emergency Set to End
As previously announced, our COVID-19 billing rules and guidelines will remain in effect through the Public Health Emergency (PHE), which expired on Thursday, May 11, 2023. As a result, some of the rules and guidelines put into place in response to the PHE will now be reversed. This means that member cost share and benefit plan rules may apply to services that were previously covered at 100% during the PHE.
Commercial and Medicare Advantage Post PHE Vaccination and Testing Coverage:
If you have questions about your coverage and COVID-19 and telehealth related costs, please call member services using the numbers below:
Commercial: 866.895.5828
Medicare Advantage: 800.455.9776
Latest on COVID-19: Testing & Vaccines
IU Health has a COVID-19 Resource Center with the latest information on testing, vaccines and more at iuhealth.org/covid19.
COVID-19 Coverage and Billing - Public Health Emergency Set to End
As previously announced, our COVID-19 billing rules and guidelines will remain in effect through the Public Health Emergency (PHE), which expired on Thursday, May 11, 2023. As a result, some of the rules and guidelines put into place in response to the PHE will now be reversed. This means that member cost share and benefit plan rules may apply to services that were previously covered at 100% during the PHE.
Commercial and Medicare Advantage Post PHE Vaccination and Testing Coverage:
If you have questions about your coverage and COVID-19 and telehealth related costs, please call member services using the numbers below:
Commercial: 866.895.5828
Medicare Advantage: 800.455.9776
Latest on COVID-19: Testing & Vaccines
IU Health has a COVID-19 Resource Center with the latest information on testing, vaccines and more at iuhealth.org/covid19.
Thank you for visiting the IU Health Plans website, we value your opinion on how we can improve your online experience. After you complete your visit, would you be willing to answer a few questions to help us improve our website? Please complete this survey after you have completed your online session.
Yes Maybe Later NeverA prescription drug formulary is a list of drugs a Medicare Advantage plan covers. The IU Health Plans (HMO and HMO POS) formulary includes thousands of brand-name and generic medications. Generic drugs have the same active-ingredient formula as a brand name drug. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs. These drugs have been approved for coverage by the health plan and are also reviewed and approved by the Centers for Medicare and Medicaid Services (CMS), the agency that administers the Medicare Program. Some of the drugs that IU Health Plans (HMO and HMO POS) cover may require you to obtain prior approval.
Click on the link below to view any drugs that require prior authorization:
Click the link below to see a list of drugs that require step therapy:
For certain prescription drugs, IU Health Plans (HMO and HMO POS) has additional requirements for coverage or limits on coverage. These requirements and limits ensure that members use these drugs in the most effective way and to control drug costs. A team of doctors and pharmacists developed these requirements and limits.
You can find out if the drug you take is subject to these additional requirements or limits by looking in the Formulary. If your drug is subject to one of these additional restrictions or limits and your physician determines that you aren’t able to meet the additional restriction or limit for medical necessity reasons, you or your physician may request an exception (which is a type of coverage determination).
We conduct drug utilization reviews for our members to make sure that they are getting safe and appropriate medications. These reviews are especially important for members who go to more than one doctor and/or pharmacy for their medications. We conduct drug utilization reviews each time you fill a prescription and on a regular basis by reviewing our records.
If we identify a medication problem during our drug utilization review, we will work with you and your doctor to correct the problem.
Indiana University Health Plans is a Medicare Advantage organization with a Medicare contract. Enrollment in an HMO or HMO POS plan from Indiana University Health Plans depends on the plan’s contract renewal with Medicare.
IU Health does not discriminate on the basis of race, color, religion, sex, sexual orientation, age, disability, genetic information, veteran status, national origin, gender identity and/or expression, marital status, or any other characteristic protected by federal, state or local law.
For language assistance call 800.455.9776 (TTY/TDD 711).
H7220_IUHMA23487 M_2023 Accepted 9.28.2022
Last updated 10.01.2022