Medical

Medical coverage provides healthcare protection for you and your family. You can visit any provider, but in-network doctors offer the highest level of benefits and lower out-of-pocket costs by charging reduced, contracted rates. Out-of-network providers set their own fees, so you may be responsible for charges above the Reasonable and Customary (R&C) limits. Preventive care—such as physical exams, flu shots, and screenings—is covered at 100% when you use in-network providers. The main differences between plan options are how much you pay per paycheck and what you pay when you receive care.

Each plan has different:

  • Annual deductible amounts – the amount you pay each year for eligible in-network and out-of-network charges before the plan begins to pay.
  • Out-of-pocket maximums– the most you will pay each year for eligible network services and/or prescriptions. After you reach your out-of-pocket maximum, the plan picks up the full cost of covered medical care for the remainder of the year.
  • Copays – A copay is a fixed amount you pay for a health care service. Copays do not count toward your deductible but do count toward your annual out-of-pocket maximum.
  • Coinsurance – Once you’ve met your deductible, you and the plan share the cost of care, which is called coinsurance. For example, you pay 20% for services and the plan will pay 80% of the cost until you have reached your out-of-pocket maximum.

Anthem CDHP PPO/HSA

Benefit Highlights
In-Network

Deductible (Individual/Family)
$1,650/$3,300

Out-of-Pocket Max (Individual/Member/Family)
$4,000/$8,000

Preventive Care
$0

Primary Care Visit
20%*

Specialist Visit
20%*

Urgent Care
20%*

Emergency Room
20%*

Retail Rx (Up to 30-Day Supply) 

Generic
$15*

Preferred Brand
$50*

Non-Preferred Brand
$70*

Specialty
30%* ($250 max copay per fill)

Mail-Order Rx (Up to 90-Day Supply)

Generic
$30*

Preferred Brand
$50*

Non-Preferred Brand
$70*

Specialty
30%* ($500 max copay per fill)

Out-of-Network

Deductible (Individual/Family)
$1,650/$3,300

Out-of-Pocket Max (Individual/Family)
$10,000/$20,000

Preventive Care
$0

Primary Care Visit
50%*

Specialist Visit
50%*

Urgent Care
50%*

Emergency Room
20%*

Retail Rx (Up to 30-Day Supply)

Generic
$15

Preferred Brand
$50

Non-Preferred Brand
$70

Specialty
30% ($250 max copay per fill)

Mail-Order Rx (Up to 90-Day Supply)

Generic
$30

Preferred Brand
$125

Non-Preferred Brand
$175

Specialty
30% ($500 max copay per fill)

Anthem Value PPO

Benefit Highlights
In-Network

Deductible (Individual/Family)
$1,000/Max 3 separate deductibles per family

Out-of-Pocket Max (Individual/Family)
$4,000/$8,000

Preventive Care
$0

Primary Care Visit
$30

Specialist Visit
$50

Urgent Care
$30

Emergency Room
20% +150 deductible (waived if admitted)

Retail Rx (Up to 30-Day Supply)

Generic
$15

Preferred Brand
$50

Non-Preferred Brand
$70

Specialty
30% ($250 max copay per fill)

Mail-Order Rx (Up to 90-Day Supply)

Generic
$30

Preferred Brand
$50

Non-Preferred Brand
$70

Specialty
30% ($500 max copay per fill)

Out-of-Network

Deductible (Individual/Family)
$2,000/Max 3 separate deductibles per family

Out-of-Pocket Max (Individual/Family)
$10,000/$20,000

Preventive Care
50%*

Primary Care Visit
50%*

Specialist Visit
50%*

Urgent Care
50%*

Emergency Room
20%* +150 deductible (waived if admitted)

Retail Rx (Up to 30-Day Supply)

Copay + 50% of Rx drug max allowed amount + costs in excess of the Rx drug max allowed amount

 

Mail-Order Rx (Up to 90-Day Supply)

Not Covered

Anthem Value HMO

Benefit Highlights
In-Network Only

Deductible (Individual/Family)
None

Out-of-Pocket Max (Individual/Family)
$3,500/$7,000

Preventive Care
$0

Primary Care Visit
$30

Specialist Visit
$50

Urgent Care
$50

Emergency Room
$150

Retail Rx (Up to 30-Day Supply)

Generic
$15

Preferred Brand
$50

Non-Preferred Brand
$70

Specialty
30% ($250 max copay per fill)

Mail-Order Rx (Up to 90-Day Supply)

Generic
$30

Preferred Brand
$125

Non-Preferred Brand
$175

Specialty
30% ($500 max copay per fill)

Kaiser HMO

Benefit Highlights
In-Network Only

Deductible (Individual/Family)
None

Out-of-Pocket Max (Individual/Family)
$3,000/$6,000

Preventive Care
$0

Primary Care Visit
$30

Specialist Visit
$300

Urgent Care
$30

Emergency Room
$150

Retail Rx (Up to 30-Day Supply)

Generic
$10

Brand
$30

Specialty
30% ($250 max copay per fill)

Mail-Order Rx (Up to 90-Day Supply)

Generic
$20

Brand
$60

*After Deductible

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