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Anthem Blue Cross Smart Sense Plus PPO |
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| For
Live Assistance , please call (818)654-4548
Oleg Skurskiy |
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| The
benefits below for Californian only ! |
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Enrollment
Applications & forms |
Anthem
Blue Cross Smart Sense Plus PPO
Plan Highlights |
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| Anthem
Blue Cross Smart Sense Plus Benefits |
| Anthem Blue Cross California Smartsense
Plus Standard Rx 1000,Anthem Blue
Cross California Smartsense Plus Standard
Rx 2000,Anthem Blue Cross California
Smartsense Plus Standard Rx 3500,
Anthem Blue Cross California Smartsense
Plus Standard Rx 6000,Anthem Blue
Cross California Smartsense Plus Upgrade
Rx 1000,Anthem Blue Cross California
Smartsense Plus Upgrade Rx 2000, Anthem
Blue Cross California Smartsense Plus
Upgrade Rx 3500,Anthem Blue Cross
California Smartsense Plus Upgrade
Rx 6000 |
Compare
side by side Smart Sense Plus |
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OUT-OF-NETWORK |
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Annual
Deductible Choices
(choose from 4 low-cost plans) |
Individual:
$6,000 Family: $12,000 Individual:
$3,500 Family: $7,000 Individual:
$2,000 Family: $4,000 Individual:
$1,000 Family: $2,000 |
Individual:
$6,000 Family: $12,000 Individual:
$3,500 Family: $7,000 Individual:
$2,000 Family: $4,000 Individual:
$1,000 Family: $2,000 |
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Lifetime
Maximum |
Unlimited |
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Annual
Out-of-Pocket Max.
(In addition to deductible) |
Individual:
$3,500 Family: $7,000 (Deductible
not Included) |
Individual:
$7,500 Family: $15,000 (Deductible
not Included) |
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Doctors'
Office Visits |
$30
per visit, 3 visits/year (additional
visits covered @ 30% after
annual deductible) |
50%
of negotiated fee plus all
excess charges |
Professional Services
(X-ray,lab,anesthesia,surgeon,etc.) |
30% of negotiated
fee |
50% of negotiated
fee plus all excess charges |
Hospital Inpatient
(Overnight Hospital Stays) |
30% of negotiated
fee |
All Charges except
$650 per day |
Hospital Inpatient
(If You Don't Stay Overnight) |
30% of negotiated fee |
All Charges except $380 per
day |
| Emergency Room
Services |
30% of negotiated
fee |
50% of customary
and reasonable fees plus excess
charges |
| Maternity |
Not covered |
| Preventive
Care |
No Charge |
50% |
| Ambulance |
30% of negotiated
fee |
50% of negotiated
fee plus excess charges |
| Physical/Occupational/Speech
Therapy; Chiropractic Services |
30% of negotiated
fee
Plan pays up to $2,500 per year
for therapy and up to $500 per
year for chiropractic services |
50% of negotiated
fee
plus all excess charges
Plan pays up to $2,500 per year
for therapy and up to $500 per
year for chiropractic services |
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Prescription Drug Coverage Options |
IN-NETWORK |
OUT-OF-NETWORK |
| SmartSense
with Generic Prescription Drug
Coverage (Drugs on Generic Rx
Formulary only) |
Generic: $15 Brand:
$40 Non-Formulary Brand: $60
($7,500 Brand Deductible, see
brochure for details) |
none
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SmartSense Plus Upgrade
Rx
Prescription Drug
Coverage (Blue Cross Formulary
Drugs) |
Generic: $15 Brand:
$40 Non-Formulary Brand: $60
($500 Brand Deductible, see
brochure for details)
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none |
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| Anthem
Blue Cross Smart Sense PPO |
What else do you get?
• Access to over 50,000 California
PPO network doctors and specialists 400
hospitals – so chances are your doctor
is one of ours
• Money in your
pocket – because we’ve negotiated
lower fees with doctors and hospitals, your
share of costs is less (a lot less)
• Free health and wellness programs
– designed to keep you as healthy
• Out-of-state coverage – so
you’ll feel better wherever you are |
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Is SmartSense for you? |
• Reliable, basic protection with
some of our lowest monthly rates
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Choose the annual deductible/monthly rate
combination that works for you
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Immediate benefits for first three visits
to a doctor
• Choice of prescription
drug benefits (Comprehensive Rx or Generic
Only Rx)
• No need for maternity
benefits
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Waiting Periods
There is a specific six-month waiting period
for coverage of any condition, disease or
ailment for which medical advice
or treatment was recommended or received
within six months preceding the effective
date of coverage. If you apply
for coverage within 63 days of terminating
your membership with another “creditable”
health care plan, then you
can use your prior coverage for credit toward
the six-month waiting period. Blue Cross
will credit the time you were
enrolled in the previous plan. Consult with
your Blue Cross agent or representative
if you have a question about the
underwriting process. |
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| Ready to Enroll?
Apply online now |
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No-Obligation Review Period
After you enroll in a plan offered by Blue
Cross of California or BC Life & Health
Insurance Company, you will receive
a Policy/EOC booklet that explains the exact
terms and conditions of coverage, including
the plan’s exclusions and
limitations. You have 10 full days to examine
your plan’s features. During that
time, if you are not fully satisfied,
you may decline by returning your Policy/EOC
booklet along with a letter notifying us
that you wish to discontinue
coverage. Policy/EOC booklets are available
for you to examine prior to enrolling. Ask
your agent or Blue Cross. |
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| New BC Life &
Health CORE 5000 , BC Life & Health Basic
PPO 1000 blue cross of california CORE 5000
blue cross SmartSense PPO
Blue Cross of California (BCC) and BC Life
& Health Insurance Company (BCL&H) are
Independent Licensees of the Blue Cross Association
(BCA). The Blue Cross name and symbol are registered
service marks of the BCA. The following plans
are offered by BCC: PPO Share 2500/1500/1000/500,
Individual HMO, HMO Saver, Select HMO, EPO and
Dental SelectHMO. The following plans are offered
by BCL&H: CORE 5000, Basic PPO 1000/2500,
PPO Saver, PPO Share 5000/1000/500, RightPlan
PPO 40, 3500 Deductible PPO, PPO 3500 (HSA-Compatible),
Short-Term PPO, Tonik, Individual PPO Dental
and Term Life
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Printable Application
Online Application