California Health Insurance
Individual Health Insurance
California Group Health
California Blue Cross
California Health Insurance Quote
California Health Insurance Plans
California Health Insurance Co.
California Health Insurance FAQ
News

Anthem Blue Cross Small Group Saver PPO Plan:

The next plan offered to your employees’ in the Anthem Blue Cross small group health plan options is the Saver PPO plan. This plan has a little different specifications than the previous PPO plan we discussed. Here is what your employees’ can expect for coverage under this plan.

Annual Deductible - For regular health services, the annual deductible is $5000. The hospital deductible is only $500, which makes it easier for your employees to handle, should they have an emergency.

Lifetime Maximum - Your employees’ will have up to $5,000,000 of coverage under this plan.

Annual Out-of-Pocket Maximum - For hospital visits or initial professional services, the out-of-pocket maximum is $2000. After this has been reached, professional services will have an out-of-pocket maximum of $5000, including the deductible.

Office Visits - Your employees’ will be allowed two initial visits, combined between in-network and out-network providers. Visits to in-network physicians will have a $20 co-pay and the deductible is waived. After this point, they will be required to pay 100% of the negotiated fee. If they have children, the children will have access to four initial visits, with a co-pay of $20, and then after the initial four visits, subsequent visits will require 100% of the negotiated fee. Visits to out-of-network physicians will cost 50% of the negotiated fee, plus 100% of any excess fees, for the first two visits for an adult, or four for a child. After this has been reached, they will need to pay 100% of the negotiated fee and 100% of any additional charges.

Hospital Inpatient Coverage - This coverage requires a preservice review. There is a $500 deductible for in-network and out-of-network hospital stays. If you employees visit an in-network hospital, they will need to pay 20% of the negotiated fee once they have met their deductible. Out-of-network hospitals will result in having to pay all charges in excess of $650 per day, once the deductible has been met.

Outpatient Facility Coverage - After the $500 deductible has been met, the charges are 20% of the negotiated fee for an in-network provider. If an out-of-network provider is used, they will need to pay for all charges, minus $380 per day, once the deductible has been met.

Diagnostic Lab and X-Ray - The first $500 worth of these charges will not be subject to the deductible every year. Covered services require a payment of 20% of the negotiated fee up to the $500 covered amount. Once this is reached, a 100% payment is required for these services. If the provider is out-of-network, this changes to 50% of the negotiated fee and 100% of any excess fees, up to the $500 coverage amount. After that point, 100% payment is required.

Prescription Drugs - Prescriptions are not subject to the annual deductible of this plan, and are charged as follows. Generic drugs have a $10 co-pay. Brand name drugs will cost $25 if a generic alternative is not available and $10 plus the difference in cost if a generic alternative is available. For self-injectable medication, excluding insulin, the cost is 30% of the negotiated fee. Medication purchased from a non participating pharmacy will require payment of 50% of the negotiated fee and 100% of any excess fees.