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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 a $0 deductible for prescription drugs. In the initial coverage phase, you'll pay a copay or coinsurance based on the drug tier and pharmacy used. For example, Tier 1 drugs have a $3.00 copay at a standard or mail-order pharmacy. For Tier 5 specialty drugs, there is no copay. After your total drug costs reach $2,000, you enter the catastrophic coverage phase where you pay nothing for Part D covered drugs.
Additional Benefits
The IU Health Plans Medicare Select Plus (HMO) plan offers comprehensive coverage, including inpatient hospital stays with a copay, outpatient services with varying copays, and ambulance services. Emergency services are covered with a copay, and you'll have access to primary care, preventive services, and hearing and vision care. Dental services are also covered with varying coinsurance amounts, along with medical equipment and home health services. This plan also includes coverage for home infusion services, dialysis, and skilled nursing facility stays. Additional benefits include coverage for diagnostic and radiological services, cardiac rehabilitation, and other services such as an over-the-counter item benefit and meal benefit. Some services like podiatry, fluoride treatment, and certain hearing aids are not covered.
Inpatient Hospital See details
Inpatient Hospital benefits are covered, with a copay of $395 for days 1-6 and no copay for days 7-90 for Inpatient Hospital-Acute, and a copay of $380 for days 1-6 and no copay for days 7-90 for Inpatient Hospital Psychiatric. Additional Days for Inpatient Hospital-Acute are covered with no copay, while Non-Medicare-covered Stay and Upgrades for Inpatient Hospital-Acute are not covered.
Outpatient Services See details
Outpatient services include coverage for outpatient hospital services and observation services, each with a $350 copay. Ambulatory Surgical Center (ASC) services have a $295 copay. Outpatient substance abuse services are covered, with individual and group sessions each having a copay between $35.00 and $35.00. Outpatient blood services are not covered.
Partial Hospitalization See details
Partial Hospitalization is covered by the IU Health Plans Medicare Select Plus (HMO) plan, but requires prior authorization. You will pay a $55 copay for this benefit.
Ambulance and Transportation Services See details
Ambulance and Transportation Services are covered by the IU Health Plans Medicare Select Plus (HMO) plan. Ground and Air Ambulance Services have a copay of $295, with no coinsurance. Transportation Services to a plan-approved health-related location are covered for 24 one-way trips per year, while transportation services to any health-related location are not covered.
Emergency Services See details
Emergency Services, Urgently Needed Services, and Worldwide Emergency Coverage are covered by IU Health Plans Medicare Select Plus (HMO), each with a copay of $125, $45, and $125 respectively, and no coinsurance. Worldwide Emergency Transportation is not covered.
Primary Care See details
The IU Health Plans Medicare Select Plus (HMO) plan covers primary care physician services, chiropractic services with a $20 copay, occupational therapy services with a $25 copay, physician specialist services with a $35 copay, mental health specialty services with a $35 copay for individual and group sessions, physical therapy and speech-language pathology services with a $25 copay, and opioid treatment program services with a $35 copay. Podiatry services are not covered.
Preventive Services See details
The IU Health Plans Medicare Select Plus (HMO) plan covers preventive services, including health education, wigs for hair loss related to chemotherapy, kidney disease education services, glaucoma screening, diabetes self-management training, barium enemas, digital rectal exams, and EKGs following a Welcome Visit. The plan does not cover In-Home Safety Assessments, Personal Emergency Response Systems, Medical Nutrition Therapy, Post-discharge In-Home Medication Reconciliation, Re-admission Prevention, Weight Management Programs, Alternative Therapies, Therapeutic Massage, Adult Day Health Services, Nutritional/Dietary Benefits, Home-Based Palliative Care, In-Home Support Services, Support for Caregivers of Enrollees, additional sessions of smoking and tobacco cessation counseling, Enhanced Disease Management, Telemonitoring Services, Remote Access Technologies, Home and Bathroom Safety Devices and Modifications, or Counseling Services.
Hearing Services See details
Hearing exams are covered with a $35 copay, and routine hearing exams are covered once per year. Prescription hearing aids are covered with a copay between $499 and $999 for all types, and the plan covers two per year, but prescription hearing aids for the inner ear, outer ear, and over the ear are not covered. Fitting/Evaluation for Hearing Aid benefits are covered. OTC hearing aids are not covered.
Vision Services See details
The IU Health Plans Medicare Select Plus (HMO) plan covers vision services, including eye exams with a $35 copay. Eyewear is covered up to a combined maximum of $250 every two years, and contact lenses, eyeglasses (lenses and frames), and eyeglass lenses and frames are also covered. Upgrades are not covered.
Dental Services See details
Dental Services include coverage for oral exams, dental x-rays, other diagnostic dental services, prophylaxis (cleaning), restorative services, adjunctive general services, and oral and maxillofacial surgery. Oral exams, dental x-rays, prophylaxis (cleaning), and adjunctive general services have no coinsurance, while restorative services and oral and maxillofacial surgery have a 50% coinsurance. Fluoride treatment, implant services, and orthodontics are not covered.
Home Infusion bundled Services See details
Home Infusion bundled Services are covered and require prior authorization. Medicare Part B Insulin Drugs have a $35 copay, while Medicare Part B Chemotherapy/Radiation Drugs and Other Medicare Part B Drugs have a coinsurance between 0% and 20%.
Dialysis Services See details
Dialysis Services are covered by the IU Health Plans Medicare Select Plus (HMO) plan. You will pay a 20% coinsurance for these services.
Medical Equipment See details
Medical Equipment benefits are covered, including Durable Medical Equipment (DME), Prosthetics/Medical Supplies, and Diabetic Equipment. DME has a 20% coinsurance with authorization required, while Durable Medical Equipment for use outside the home is not covered. Prosthetics/Medical Supplies has a 20% coinsurance for Medicare-covered Prosthetic Devices and Medical Supplies, and Diabetic Therapeutic Shoes/Inserts have a 20% coinsurance.
Diagnostic and Radiological Services See details
Diagnostic and Radiological Services are covered, including Diagnostic Procedures/Tests with a coinsurance of up to 20%, Lab Services with no copay, Diagnostic Radiological Services with a coinsurance of at least 0%, Therapeutic Radiological Services with a coinsurance of at least 20%, and Outpatient X-Ray Services with a $25 copay. All of these services require prior authorization.
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
Cardiac Rehabilitation Services are covered by the IU Health Plans Medicare Select Plus (HMO) plan, but the plan does not cover Cardiac Rehabilitation Services, Intensive Cardiac Rehabilitation Services, Pulmonary Rehabilitation Services, or SET for PAD Services. The copay information is available in the plan details.
Skilled Nursing Facility (SNF) See details
Skilled Nursing Facility (SNF) services are covered by the IU Health Plans Medicare Select Plus (HMO) plan, but require prior authorization. For days 1-20, there is no copay, and for days 21-100, the copay is $214. Additional days beyond Medicare-covered and non-Medicare-covered SNF stays are not covered.
Other Services See details
Other Services includes coverage for Over-the-Counter (OTC) Items and Meal Benefit, but does not cover 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, or Self-Directed Personal Assistance Services. The OTC benefit provides up to $40 every three months for covered items. The Meal Benefit requires prior authorization.
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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.
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