2025 FAQ

2025 FAQ What does it mean for a medical plan to have two tiers of coverage? Whether you choose PPO Option 1 or PPO Option 2, you will ond that there are two tiers of coverage with diferent copays, deductibles, and out-of-pocket maximums. Each tier accumulates out of pocket expenses separately, so if you have care with a Tier 2 provider, those expenses you paid out of pocket are not counted toward your Tier 1 deductible. How do I ond a provider in network with Anthem HealthSync before my coverage is active? The simplest way to ond a provider in the Anthem HealthSync network today is to visit the Anthem web portal, select Find Care in the upper right corner, and follow this path: Select a plan for basic search → Medical Plan or Network → Indiana → Medical (Employer-Sponsored) → Anthem HealthSync Options POS. Then, you’ll enter your zip code and select Search for care to ond HealthSync providers in your area. How do I ond a provider in network with Anthem HealthSync after my coverage is active? It’s very simple to ond a network provider as an active Anthem member! When you register for an account on the Anthem member portal or download the Sydney Health app, there’s a simple search function for providers in your area organized by specialty. Are we still using TrueScripts as our pharmacy beneot administrator? Yes! Your drugs will continue to be administered through TrueScripts in 2025. The major healthcare providers in Huntington County are Parkview and Lutheran. Where should I go? As a healthcare consumer you should always select a provider that makes you comfortable. You can continue to access care wherever you feel is best. However, the new Lutheran facility that recently opened is considered a Tier 1 facility, which would mean a lower deductible for your family’s care. The Parkview facilities are in the Tier 2 network, which would mean higher deductibles for your family. My doctor is in the Parkview hospital system. Do I have to ond a new one? Most doctors in the Parkview system are in your Anthem HealthSync network as Tier 2 providers. Remember that both Anthem PPO Plan #1 and PPO Plan #2 ofer two tiers of coverage depending on which types of healthcare providers (doctors, hospital systems, etc.) you use. Since Anthem has negotiated the best discounts with their high-performing Tier 1 providers, you will have a lower deductible than if you use a Tier 2 provider. Please reference the 2025 plan summaries and the medical plan design page of your 2025 beneot guide to see how your deductible will be higher with Tier 2 providers than with Tier 1. In summary: most Parkview doctors are in your Anthem network, but you may have a higher deductible to meet for your healthcare services before the Plan’s coinsurance begins to cover the majority of your remaining covered expenses (known as coinsurance).