Anthem Blue Cross Ppo Copay

1. Blue Cross Blue Shield Ppo Copay
2. Anthem Blue Cross Preferred Ppo
3. Is Anthem Blue Cross Ppo Good Insurance
4. Anthem Blue Cross Ppo Plan
5. Anthem Blue Cross Ppo Providers

The percentage copay for non -emergency services from non Anthem Blue Cross PPO providers is based on the scheduled amount. The dollar copay applies only to the visit itself. An additional 20% copay applies for any services performed in office (i.e., X-ray, lab, surgery), after any applicable deductible. $150 copay and then 25% coinsurance This is for the hospital/facility charge only. The ER physician charge may be separate. Copay waived if admitted Emergency Medical Transportation 25% coinsurance 25% coinsurance –––––––––––none––––––––––– Urgent Care $25 copay per visit 50% coinsurance.

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

Below are some of our most popular Anthem Blue Cross health plans along with a snapshot of plan coverage and out-of-pocket costs. For a complete list of coverage options, click Download All Plans below to see the most current plan information.

• Network	Prudent Buyer - Small Group
  Calendar Year Deductible	$1,350 / $2,700	Out of Network$500 / $1,500	Out of Network$5,600 / $11,200 (combined Med/Rx/Pediatric dental ded)(applies to Max OOPM)
  Out-of-Pocket Max Ind/Fam:	$8,000 / $16,000
  Dr. Office Visit (PCP):	$65 Copay (first 3 visits) - $65 Copay
  Urgent Care:	60%
  Emergency Room	$300 Copay - 60%

  Network	Advantage PPO	Out of Network
  Calendar Year Deductible	$2,700 / $5,400
  Out-of-Pocket Max Ind/Fam:	$7,900 / $15,800	$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%

  Network	Advantage PPO	Out of Network
  Calendar Year Deductible	$2,000 / $4,000
  Out-of-Pocket Max Ind/Fam:	$6,000 / $12,000	$12,000 / $24,000
  Dr. Office Visit (PCP):	$30 Copay (ded waived)	50%
  Urgent Care:	$60 Copay (ded waived)	50%
  Emergency Room	$250 Copay - 80%

  Network	Select HMO
  Calendar Year Deductible	None
  Out-of-Pocket Max Ind/Fam:	$2,200 / $4,400
  Dr. Office Visit (PCP):	$15 Copay
  Urgent Care:	$15 Copay
  Emergency Room	$200 Copay

  * All services are subject to the deductible unless otherwise stated. Shifter dnd.

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  Anthem MediBlue Access Core (PPO) H4036-016 is a 2021 Medicare Advantage Plan or Medicare Part-C plan by Anthem Blue Cross and Blue Shield available to residents in Wisconsin. This plan does not provide additional Medicare prescription drug (Part-D) coverage. The Anthem MediBlue Access Core (PPO) has a monthly premium of $0 and has an in-network Maximum Out-of-Pocket limit of $5,500 (MOOP). This means that if you get sick or need a high cost procedure the co-pays are capped once you pay $5,500 out of pocket. This can be a extremely nice safety net.

  Anthem MediBlue Access Core (PPO) is a Local PPO *. A preferred provider organization (PPO) is a Medicare plan that has created contracts with a network of 'preferred' providers for you to choose from at reduced rates. You do not need to select a primary care physician and you do not need referrals to see other providers in the network. Offering you a little more flexibility overall. You can get medical attention from a provider outside of the network but you will have to pay the difference between the out-of-network bill and the PPOs discounted rate.

  Anthem Blue Cross and Blue Shield works with Medicare to provide significant coverage beyond Part A and Part B benefits. If you decide to sign up for Anthem MediBlue Access Core (PPO) you still retain Original Medicare. But you will get additional Part A (Hospital Insurance) and Part B (Medical Insurance) coverage from Anthem Blue Cross and Blue Shield and not Original Medicare. With Medicare Advantage Plans you are always covered for urgently needed and emergency care. Plus you receive all of the benefits of Original Medicare from Anthem Blue Cross and Blue Shield except hospice care. Original Medicare still provides you with hospice care even if you sign up for a Medicare Advantage Plan.

  
  
  

  Ready to Enroll?
  

  
  

  Or Call
  1-855-778-4180
  Mon-Fri 8am-9pm EST
  Sat 9am-9pm EST
  

  
  
  

  2021 Anthem Blue Cross and Blue Shield Medicare Advantage Plan Costs

  Name:
  Plan ID:	H4036-016
  Provider:	Anthem Blue Cross and Blue Shield
  Year:	2021
  Type:	Local PPO *
  Monthly Premium C+D:	$0
  Part C Premium:
  MOOP:	$5,500
  Similar Plan:	H4036-017

  
  

  2021 Anthem MediBlue Access Core (PPO) Summary of Benefits

  
  
  

  Additional Benefits

  
  

  No

  
  
  

  Comprehensive Dental

  
  

  Diagnostic services	$0 copay
  Diagnostic services	$0 copay (Out-of-Network)
  Endodontics	$0 copay
  Endodontics	$0 copay (Out-of-Network)
  Extractions	$0 copay
  Extractions	$0 copay (Out-of-Network)
  Non-routine services	$0 copay
  Non-routine services	$0 copay (Out-of-Network)
  Periodontics	$0 copay
  Periodontics	$0 copay (Out-of-Network)
  Prosthodontics, other oral/maxillofacial surgery, other services	$0 copay
  Prosthodontics, other oral/maxillofacial surgery, other services	$0 copay (Out-of-Network)
  Restorative services	$0 copay
  Restorative services	$0 copay (Out-of-Network)

  
  
  

  Deductible

  
  

  $500 annual deductible

  
  
  

  Diagnostic Tests and Procedures

  
  

  Diagnostic radiology services (e.g., MRI)	$130-215 copay
  Diagnostic radiology services (e.g., MRI)	35% coinsurance (Out-of-Network)
  Diagnostic tests and procedures	$0-150 copay
  Diagnostic tests and procedures	35% coinsurance (Out-of-Network)
  Lab services	$0-10 copay
  Lab services	35% coinsurance (Out-of-Network)
  Outpatient x-rays	$50-110 copay
  Outpatient x-rays	35% coinsurance (Out-of-Network)

  
  
  

  Doctor Visits

  
  

  Primary	$40 copay per visit (Out-of-Network)
  Primary	$5 copay per visit
  Specialist	$40 copay per visit
  Specialist	$60 copay per visit (Out-of-Network)

  
  
  

  Emergency care/Urgent Care

  
  

  Emergency	$90 copay per visit (always covered)
  Urgent care	$35 copay per visit (always covered)

  
  
  

  Foot Care (podiatry services)

  
  

  Foot exams and treatment	$0-40 copay
  Foot exams and treatment	$60 copay (Out-of-Network)
  Routine foot care	$0 copay
  Routine foot care	$60 copay (Out-of-Network)

  
  
  

  Ground Ambulance

  
  

  $265 copay
  $265 copay (Out-of-Network)

  
  
  

  Hearing

  
  

  Fitting/evaluation	$0 copay
  Fitting/evaluation	20% coinsurance (Out-of-Network)
  Hearing aids	$0 copay
  Hearing aids	50% coinsurance (Out-of-Network)
  Hearing exam	$40 copay
  Hearing exam	$60 copay (Out-of-Network)

  
  
  

  Inpatient Hospital Coverage

  
  

  $295 per day for days 1 through 7 $0 per day for days 8 through 90
  50% per stay (Out-of-Network)

  
  
  

  Medical Equipment/Supplies

  
  

  Diabetes supplies	$0 copay
  Diabetes supplies	40% coinsurance per item (Out-of-Network)
  Durable medical equipment (e.g., wheelchairs, oxygen)	0-20% coinsurance per item
  Durable medical equipment (e.g., wheelchairs, oxygen)	40% coinsurance per item (Out-of-Network)
  Prosthetics (e.g., braces, artificial limbs)	20% coinsurance per item
  Prosthetics (e.g., braces, artificial limbs)	40% coinsurance per item (Out-of-Network)

  
  
  

  Medicare Part B Drugs

  
  

  Chemotherapy	20% coinsurance
  Chemotherapy	40% coinsurance (Out-of-Network)
  Other Part B drugs	20% coinsurance
  Other Part B drugs	40% coinsurance (Out-of-Network)

  
  
  

  Mental Health Services

  
  

  Blue Cross Blue Shield Ppo Copay

  Inpatient hospital - psychiatric	$250 per day for days 1 through 7 $0 per day for days 8 through 90
  Inpatient hospital - psychiatric	50% per stay (Out-of-Network)
  Outpatient group therapy visit	$40 copay
  Outpatient group therapy visit	$60 copay (Out-of-Network)
  Outpatient group therapy visit with a psychiatrist	$40 copay
  Outpatient group therapy visit with a psychiatrist	$60 copay (Out-of-Network)
  Outpatient individual therapy visit	$40 copay
  Outpatient individual therapy visit	$60 copay (Out-of-Network)
  Outpatient individual therapy visit with a psychiatrist	$40 copay
  Outpatient individual therapy visit with a psychiatrist	$60 copay (Out-of-Network)

  
  
  

  MOOP

  
  

Option

Optional supplemental benefits

Outpatient Hospital Coverage

Package #1

Package #2

Package #3

Preventive Care

Preventive Dental

Rehabilitation Services

Option

Optional supplemental benefits

Outpatient Hospital Coverage

Package #1

Package #2

Package #3

Preventive Care

Preventive Dental

Rehabilitation Services

Skilled Nursing Facility

Transportation

Vision

Wellness Programs (e.g. fitness nursing hotline)

Reviews for Anthem MediBlue Access Core (PPO) H4036

Staying Healthy, Screening, Testing, & Vaccines

Managing Chronic And Long Term Care for Older Adults

Member Experience with Health Plan

Member Complaints and Changes in Anthem MediBlue Access Core (PPO) Plans Performance

Health Plan Customer Service Rating for Anthem MediBlue Access Core (PPO)

Anthem MediBlue Access Core (PPO) Drug Plan Customer Service Ratings

Ratings For Member Complaints and Changes in the Drug Plans Performance

Member Experience with the Drug Plan

Anthem Blue Cross Preferred Ppo

Drug Safety and Accuracy of Drug Pricing

Ready to Enroll?

Or Call
1-855-778-4180
Mon-Sat 8am-11pm EST
Sun 9am-6pm EST

Is Anthem Blue Cross Ppo Good Insurance

Anthem Blue Cross Ppo Plan

Coverage Area for Anthem MediBlue Access Core (PPO)

(Click county to compare all available Advantage plans)

Anthem Blue Cross Ppo Providers

Source: CMS.
Data as of September 9, 2020.
Notes: Data are subject to change as contracts are finalized. For 2021, enhanced alternative may offer additional cost sharing reductions in the gap on a sub-set of the formulary drugs, beyond the standard Part D benefit.Includes 2021 approved contracts. Employer sponsored 800 series and plans under sanction are excluded.