Indiana Plan Benefit Materials


This booklet gives you a summary of costs and coverage in your plan. Please select the document for your plan and county:

For HMO Members

Plan Name CMS # County Summary of Benefits
Ascension Complete St. Vincent Reward (HMO) H7925- 001 Boone, Gibson, Hamilton, Hancock, Hendricks, Howard, Madison, Montgomery, Posey, Putnam, Shelby, Vanderburgh and Warrick counties
Ascension Complete St. Vincent Secure (HMO) H7925- 002 Boone, Gibson, Hamilton, Hancock, Hendricks, Howard, Madison, Montgomery, Posey, Putnam, Shelby, Vanderburgh and Warrick counties

For HMO D SNP Members

Plan Name CMS # County Summary of Benefits
Ascension Complete St. Vincent Reward (HMO D-SNP) H7925- 003 Boone, Gibson, Hamilton, Hancock, Hendricks, Howard, Madison, Montgomery, Posey, Putnam, Shelby, Vanderburgh and Warrick counties

For PPO Members

Plan Name CMS # County Summary of Benefits
Ascension Complete St. Vincent Access Plus (PPO) H1774- 001 Boone, Gibson, Hamilton, Hancock, Hendricks, Howard, Madison, Montgomery, Posey, Putnam, Shelby, Vanderburgh and Warrick counties
Ascension Complete St. Vincent Access (PPO) H1774- 002 Boone, Gibson, Hamilton, Hancock, Hendricks, Howard, Madison, Montgomery, Posey, Putnam, Shelby, Vanderburgh and Warrick counties

This booklet gives you a complete list of services, limitations and exclusions for your plan coverage. Please select the document for your plan and county:

For HMO Members

Plan Name CMS # County Evidence of Coverage (EOC)
Ascension Complete St. Vincent Reward (HMO) H7925- 001 Boone, Gibson, Hamilton, Hancock, Hendricks, Howard, Madison, Montgomery, Posey, Putnam, Shelby, Vanderburgh and Warrick counties
Ascension Complete St. Vincent Secure (HMO) H7925- 002 Boone, Gibson, Hamilton, Hancock, Hendricks, Howard, Madison, Montgomery, Posey, Putnam, Shelby, Vanderburgh and Warrick counties

For HMO D SNP Members

Plan Name CMS # County Evidence of Coverage (EOC)
Ascension Complete St. Vincent Reward (HMO) H7925- 003 Boone, Gibson, Hamilton, Hancock, Hendricks, Howard, Madison, Montgomery, Posey, Putnam, Shelby, Vanderburgh and Warrick counties

For PPO Members

Plan Name CMS # County Evidence of Coverage (EOC)
Ascension Complete St. Vincent Access Plus (PPO) H1774- 001 Boone, Gibson, Hamilton, Hancock, Hendricks, Howard, Madison, Montgomery, Posey, Putnam, Shelby, Vanderburgh and Warrick counties
Ascension Complete St. Vincent Access Plus (PPO) H1774- 002 Boone, Gibson, Hamilton, Hancock, Hendricks, Howard, Madison, Montgomery, Posey, Putnam, Shelby, Vanderburgh and Warrick counties

If you were enrolled in Ascension Complete last year, this booklet will tell you about changes to your plan’s costs and benefits for the coming year. Please select the document for your plan and county:

For HMO Members

Plan Name CMS # County Annual Notice of Changes (ANOC)
Ascension Complete St. Vincent Reward (HMO) H7925- 001 Boone, Gibson, Hamilton, Hancock, Hendricks, Howard, Madison, Montgomery, Posey, Putnam, Shelby, Vanderburgh and Warrick counties
Ascension Complete St. Vincent Secure (HMO) H7925- 002 Boone, Gibson, Hamilton, Hancock, Hendricks, Howard, Madison, Montgomery, Posey, Putnam, Shelby, Vanderburgh and Warrick counties

For PPO Members

Plan Name CMS # County Annual Notice of Changes
Ascension Complete St. Vincent Access Plus (PPO) H1774- 001 Boone, Gibson, Hamilton, Hancock, Hendricks, Howard, Madison, Montgomery, Posey, Putnam, Shelby, Vanderburgh and Warrick counties

If you have questions please, contact Member Services.