About Anthem Blue Cross
Anthem Blue Cross offers the health insurance coverage and choices you – and your employees – want and need. You can select from a variety of plan types, including HMO, PPO, EPO, and Health Savings Account-compatible plans. Anthem has the largest provider network in the nation (and in California), so you’re likely to find that your preferred doctor is already in-network – saving you money and time.
Don’t forget about Anthem’s smart tools designed to help employees make the most of their group health benefits. It’s easy to find a doctor, access your virtual ID card, or get plan information, claims data, and other info with the Anthem Anywhere mobile app. Click below to explore the details on any of the Anthem plans available through CaliforniaChoice.
Quick Plan Highlights
Here are some of our most popular Anthem Blue Cross health plans along with a high level snapshot of plan coverage and out-of-pocket costs. To view a complete list of Anthem Blue Cross coverage options, click Download All Plans below to see the most current plan information.
These plans are effective beginning: 1/1/19
Bronze EPO A
Silver PPO A
Network Advantage PPO Calendar Year Deductible In Network $1,350 / $2,700 Out of Network4 $2,700 / $5,400 Out-of-Pocket Max Ind/Fam: $7,900 / $15,8002 $15,800 / $31,600 Dr. Office Visit (PCP): $40 Copay (ded waived) 50% Urgent Care: $80 Copay (ded waived) 50% Emergency Room $350 Copay - 60% $350 Copay - 60%
Gold PPO A
Network Advantage PPO Calendar Year Deductible In Network
$500 / $1,500
Out of Network4 $2,000 / $4,000 Out-of-Pocket Max Ind/Fam: $6,000 / $12,0002 $12,000 / $24,0001 Dr. Office Visit (PCP): $30 Copay (ded waived) 50% Urgent Care: $60 Copay (ded waived) 50% Emergency Room $250 Copay - 80% $250 Copay - 80%
Platinum HMO A
Network Select HMO Calendar Year Deductible None Out-of-Pocket Max Ind/Fam: $2,000 / $4,0002 Dr. Office Visit (PCP): $15 Copay Urgent Care: $15 Copay Emergency Room $200 Copay
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* All services are subject to the deductible unless otherwise stated.
1) Family Deductible: For any given Member, cost share applies either after he/she meets their individual Deductible, or after the entire family Deductible is met. The family Deductible can be met by any combination of amounts from any Member; however, no one Member may contribute any more than his/her individual Deductible toward the family Deductible.
2) Family out-of-pocket limit: For any given member, the out-of-pocket limit is met either after he/she meets their individual out-of-pocket limit, or after the entire family out-of-pocket limit is met. The family out-of-pocket limit can be met by any combination of amounts from any member; however, no one member may contribute any more than his/her individual out-of-pocket limit toward the family out-of-pocket limit.
3) Office visits are per member and combined for primary care physician, specialist, other provider, Counseling (including Family Planning, Nutritional), and Telehealth. These Office Visits have a Co-payment with deductible waived for in-network providers which applies to any combination of services for the first three visits during the Benefit Period. Starting with the fourth visit, you pay Deductible and then a Co-payment. Always check the setting above to determining your payment responsibility for other services and Providers, if applicable. Benefits are based on the setting in which Covered Services are received. If the service is available (and you obtain the service) in a setting other than the one listed above, your Co-payment /Coinsurance will be based on the setting in which, you receive the service. Please see those settings to determine your cost share.
4) When you use an out-of-network provider, you will have higher cost sharing amounts to pay. Anthem’s payment is based on a maximum allowed amount (includes certain benefits with maximum payment limits) and an out-of-network provider can charge you for amounts in excess of the Maximum Allowed Amount (there is an exception for Emergency Care received in California). In addition, only the maximum allowed amount for out of network services is applied towards your Out-of-Network deductible and out of pocket.
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The CaliforniaChoice employee benefits program lets your employees select health
(HMO, PPO, HSA, and more) from eight of California's top carriers while you determine how much
company will contribute.