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IU Health Plans Medicare Select Plus (HMO)
Benefits Summary and Overview
This page is a benefits summary and overview of key plan information for IU Health Plans Medicare Select Plus (HMO). The information on this page is a summary only.
For a complete listing of all available benefits and cost information on IU Health Plans Medicare Select Plus (HMO) in 2025, please refer to our full plan details page.
IU Health Plans Medicare Select Plus (HMO) is a HMO plan offered by Indiana University Health available for enrollment in 2025 to people living in Indianapolis Metro Area and Surrounding Counties. This plan received an overall rating of 3.5 out of 5 stars in 2025.
It's important to know that IU Health Plans Medicare Select Plus (HMO) is a Medicare Advantage (MA) Plan with drug coverage. That means that this plan covers both medical services and prescription drugs.
Key Plan Facts
Below are a few key facts and commonly-asked questions about IU Health Plans Medicare Select Plus (HMO).
Plan Costs:
The cost of a Medicare Advantage Plan is made up of four main parts.
- First, the monthly premium — the amount you pay every month.
- Second, the deductible — the amount you pay out of pocket for covered services before the plan starts paying.
- Third, the copayments and coinsurance — the amounts you pay out of pocket for covered services, usually after meeting the deductible (if applicable). Copays are fixed dollar amounts; coinsurance is a percentage of the cost.
- Fourth, the Out-of-Pocket Maximum — the maximum amount you could have to pay out of pocket in a year. This may be different for in-network and out-of-network services.
For IU Health Plans Medicare Select Plus (HMO), the main costs are as follows:
Monthly Premium
The Monthly Premium for this plan is $0.00. This is the amount you must pay every month.
This plan does not come with a Part B Premium reduction. You must continue to pay your Part B premium.
Deductibles
This plan does not have a health deductible. Your insurance coverage on covered health services will start immediately.
This plan has no drug deductible. Your prescription medication coverage will start immediately.
Out-of-Pocket Maximums
This plan has a Maximum Out-Of-Pocket cost of $4400.00 for out-of-network services. You will pay copays, coinsurance, and deductibles toward this amount. Once your total out-of-pocket costs reach $0.00 for in-network covered services, the plan will pay 100% of in-network covered costs for the rest of the year.
You can see below for the coinsurance and specific copayments for in the Additional Benefits section below, or refer to our Plan Details page for more details.
Common Services:
Doctor Visits:
Specialist Visits:
Emergency Room:
Urgent Care:
Sign up for IU Health Plans Medicare Select Plus (HMO)
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Drug Coverage
The IU Health Plans Medicare Select Plus (HMO) plan has an "Enhanced Alternative" drug benefit. This plan has no deductible for prescription drugs. In the initial coverage phase, you may pay a copay or coinsurance depending on the drug tier and pharmacy. For example, you will pay a $3.00 copay for preferred generic drugs at a standard pharmacy, and 50% coinsurance for preferred brand drugs. Once your total drug costs reach $2,000, you enter the catastrophic coverage phase, where you pay nothing for covered drugs.
Additional Benefits
The IU Health Plans Medicare Select Plus (HMO) plan offers a range of benefits with varying costs. Inpatient hospital stays have copays, while outpatient services such as hospital services and substance abuse services have copays. Emergency and urgent care services have copays, and ambulance services also have a copay. This plan covers primary care visits with a low or no copay, and specialist visits have a copay. Preventive services are covered with no copay, and vision and dental services are included with copays or coinsurance for some services. Hearing exams and hearing aids are covered with a copay. The plan also includes coverage for home health services and medical equipment with coinsurance, as well as dialysis services.
Inpatient Hospital See details
Inpatient Hospital benefits, including Inpatient Hospital-Acute and Inpatient Hospital Psychiatric, are covered with prior authorization. For Inpatient Hospital-Acute, you will pay a $395 copay for days 1-6, and no copay for days 7-90; for Inpatient Hospital Psychiatric, you will pay a $380 copay for days 1-6, and no copay for days 7-90. Additional Days for Inpatient Hospital-Acute are covered with no copay. Non-Medicare-covered Stay for Inpatient Hospital-Acute, Upgrades for Inpatient Hospital-Acute, Additional Days for Inpatient Hospital Psychiatric, and Non-Medicare-covered Stay for Inpatient Hospital Psychiatric are not covered.
Outpatient Services See details
Outpatient services include coverage for outpatient hospital services and observation services with a $350 copay, ambulatory surgical center services with a $295 copay, and outpatient substance abuse services with a copay between $35 and $35. Outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered, but requires prior authorization. You will have a $55 copay for this service.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered, with a $295 copay for both ground and air ambulance services. Transportation Services to plan-approved health-related locations are covered for up to 24 one-way trips per year. Transportation Services to any health-related location is not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered by the IU Health Plans Medicare Select Plus (HMO) plan. Emergency Services have a $125 copay, and Urgently Needed Services have a $45 copay. Worldwide Emergency Coverage and Worldwide Urgent Coverage each have a $125 copay, but Worldwide Emergency Transportation is not covered.
Primary Care See details
The IU Health Plans Medicare Select Plus (HMO) plan covers primary care physician services with a copay between $0-$10, and chiropractic services with a $20 copay. Occupational therapy has a $25 copay, while specialist services have a $35 copay. Mental health and psychiatric individual and group sessions have a $35 copay. Physical therapy and speech-language pathology services have a $25 copay. Opioid treatment program services have a $35 copay. Routine chiropractic care and podiatry services are not covered.
Preventive Services See details
Preventive Services are covered, including Medicare-covered preventive services, annual physical exams, and additional preventive services, with no copay or coinsurance for most services. Some additional services like In-Home Safety Assessment, Personal Emergency Response System (PERS), Medical Nutrition Therapy (MNT), and others are not covered.
Hearing Services See details
The IU Health Plans Medicare Select Plus (HMO) plan covers hearing exams with a $35 copay, routine hearing exams (1 visit per year), and fitting/evaluation for hearing aids. Prescription hearing aids (all types) are covered with a copay between $499 and $999 for up to 2 visits per year, while prescription hearing aids for inner ear, outer ear, and over the ear are not covered, nor are OTC hearing aids.
Vision Services See details
Vision Services includes coverage for eye exams with a $35 copay, and covers routine eye exams once per year. Eyewear is covered, with a combined maximum benefit of $250 every two years, and includes contact lenses, eyeglasses (lenses and frames), eyeglass lenses and eyeglass frames.
Dental Services See details
The IU Health Plans Medicare Select Plus (HMO) plan covers dental services, including oral exams, dental x-rays, prophylaxis (cleaning), restorative services, and adjunctive general services. Oral exams, dental x-rays, and prophylaxis (cleaning) have no coinsurance, but fluoride treatment, implant services, and orthodontics are not covered. Restorative services and oral and maxillofacial surgery have a 50% coinsurance.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered, including Medicare Part B Insulin Drugs with a $35 copay, and Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs with 0-20% coinsurance. Prior authorization is required.
Dialysis Services See details
Dialysis Services are covered by the IU Health Plans Medicare Select Plus (HMO) plan. You will pay 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment is covered under the IU Health Plans Medicare Select Plus (HMO) plan, with Durable Medical Equipment (DME) and Prosthetic Devices subject to 20% coinsurance and no copay, while Durable Medical Equipment for use outside the home and Diabetic Supplies are not covered. Medical Supplies are covered with 20% coinsurance and no copay, and Diabetic Therapeutic Shoes/Inserts are covered with a 20% coinsurance and no copay.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered. Diagnostic Procedures/Tests and Therapeutic Radiological Services have a coinsurance of at most 20%, while Lab Services have no copay and Diagnostic Radiological Services have no coinsurance. Outpatient X-Ray Services have a $30 copay.
Home Health Services See details
Home Health Services are covered by the IU Health Plans Medicare Select Plus (HMO) plan with no copay and no coinsurance, but additional hours of care and personal care services are not covered. Prior authorization is required for this benefit.
Cardiac Rehabilitation Services See details
IU Health Plans Medicare Select Plus (HMO) does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. There is a copay for some services, but the specific copay information is not provided.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered with prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered for SNF and non-Medicare-covered stays for SNF are not covered.
Other Services See details
Other Services include Over-the-Counter (OTC) Items with a maximum benefit of $40 every three months, and Meal Benefit, which requires prior authorization. Acupuncture, Dual Eligible SNPs with Highly Integrated Services, Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services, Private Duty Nursing Services, Case Management (Long Term Care), Institution for Mental Disease Services for Individuals 65 or Older, Services in an Intermediate Care Facility for Individuals with Intellectual Disabilities, Case Management, Tobacco Cessation Counseling for Pregnant Women, Freestanding Birth Center Services, Respiratory Care Services, Family Planning Services, Nursing Home Services, Home and Community Based Services, Personal Care Services, and Self-Directed Personal Assistance Services are not covered.
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