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.