2026 Health Plan FAQ

2026 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 find that there are two tiers of coverage with different 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 find a provider in network with Anthem HealthSync? It’s very simple to find 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 benefit administrator? No – your prescription drug plan will be administered by Navitus in 2026. You will receive a new health insurance card in the mail prior to 1/1/2026 that will contain updated Rx information. What changes can I expect with our new pharmacy benefit manager, Navitus? You will notice very little change to your pharmacy benefit administration. If you use specialty medications, you will work directly with Navitus’s partners at Lumicera Health Services – please contact their specialists at 855- 847-3553 to learn more. If you would like to save time and money on maintenance medications, consider using the Costco mail order pharmacy! If you are using a brand-name drug, you may be eligible for manufacturer copay assistance; please contact Navitus’s Customer Care at 855-847-1025 to learn more. I am already on a copay assistance program. Do I have to sign up again? No, you do not need to sign up again. However, contact Customer Care at 855-847-1025 to let us know you are already in the program. This will prevent any issues at the pharmacy. 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.