MEDICARE MEMBERS: PROTECT YOURSELF AGAINST MEDICARE FRAUD AND IDENTIFY THEFT! THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES OFFICE OF INSPECTOR GENERAL IS ALERTING THE PUBLIC ABOUT A FRAUD SCHEME INVOLVING GENETIC TESTING. LEARN HOW TO PROTECT YOURSELF.
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 DSNP (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
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.