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 PPO Members
Plan Name
CMS #
County
Summary of Benefits
Ascension Complete St. Vincent Access (PPO)
H1774- 001
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 PPO Members
Plan Name
CMS #
County
Evidence of Coverage (EOC)
Ascension Complete St. Vincent Access (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.