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Anthem Blue Cross BlueShield of Indiana
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Anthem BCBS Indiana - SmartSense Plus Plans

SmartSense Plus Plans

Our Rating:

The SmartSense plan provides coverage for 3 office visits per year to a primary care physician or specialist with a $35 office visit copay. Additional doctor visits are subject to the plan deductible.

A "Standard" and "Upgrade" prescription benefit is available. If the "Standard" option is selected, Non-Formulary drugs will only receive the Anthem negotiated discount. The "Upgrade" benefit includes a combination of copays and coinsurance, depending on the type of drug.

Preventive benefits are also included at 100% coverage with no waiting periods, copays or coinsurance. Unlike the SmartSense Plus plan, maternity benefits are not available as a rider. However, dental and vision riders are available on both the plans.

The Anthem Indiana SmartSense plan costs substantially less than the SmartSense Plus plan and is recommended for persons that want affordable coverage without some extra benefits that may not be used.

SmartSense Plan Highlights include:

  • Limited $35 office visit co-pay benefit (3 visits per year)
  • Choice of 70% or 50% coinsurance
  • Access to the Blue Access PPO Network
  • Standard Drug Coverage - $15 presciption co-payment for generic drugs, member is responsible for entire cost of drugs not on the formulary after applied Anthem discount
  • Upgrade Drug Coverage - $15 presciption co-payment for generic drugs, greater of $30 co-pay or 40% coinsurance for brand drugs after $250 Rx Deductible per member
  • Unlimited lifetime maximum

The SmartSense Plans do NOT cover:

  • Maternity Benefits
  • Brand name drugs unless the optional drug coverage upgrade is selected