Anthem PPO

Preventive Care: The plan pays 100% for in-network preventive care.

Annual Deductible: For non-preventive care there is an annual deductible that must be met. The annual deductible is $5,000 for Individual coverage and $10,000 for Family coverage when you use in-network providers.

Coinsurance: Once you have met the deductible, you will pay coinsurance for services received. When you use in-network providers, your coinsurance cost will be 0% for individual and family.

Out-of-Pocket Maximum: This is the most that you will have to pay for covered services in a plan year. The medical and prescription drug deductible, copayments and coinsurance all apply toward the out-of-pocket maximum. Once you meet the out-of-pocket maximum, then the plan pays 100% of your eligible expenses, including the cost of all office visits and prescription drugs, for the remainder of the year.

LiveHealth Online (LHO): This is Anthem’s telemedicine option. MDLive lets you get the care you need – including most prescriptions (when appropriate) – for a wide range of minor conditions. You can connect with a board certified provider via video chat or phone, when, where and how it works best for you. Download the LHO flyers in the Resource Box for additional information.

Health Reimbursement Arrangement (HRA): Singles are responsible for the first $500 and those covering dependents responsible for the first $1,000.  Additional information can be found in the summary under resources.