Anthem blue cross of California offers a broad range of health plans, varying costs, levels of health coverage, and accessibility to health care. These are important considerations for helping you identify which plan is right for you.

The plan type you choose will determine how you select and access health care services. In general, the wider your choice of doctors and hospitals, the higher your costs will be in terms of premiums and/or levels of health care coverage.

The PPO Plans offer you the most flexibility in your choice of doctors and hospitals (providers). PPO Plans provide coverage (at different levels) for services from both Participating and Non-Participating Providers. Please see he PPO Plan section of this brochure for definitions of these and other terms related to PPO Plan Coverage.

• Price — What are the monthly premiums for each plan? What can you afford?
  
• Features — What health care services does each program cover?
  
• Cost-sharing — What would be your share of the cost for these services?
  
• Access — Is it important to you to see any doctor you want or are you willing to trade that flexibility for some other benefit?

• Deductible = the amount you pay each year for covered services before your plan begins paying part of the cost.

• Out-of-Pocket Maximum = The maximum amount for qualifying covered services you would have to spend in any one year, including your deductible, before your plan pays 100% of your covered costs for most services.

For complete rate information, go to Easy Guide to the Rates.

PPO PLAN SELECTIONS

PlanScape® PPO Share Plans

The Anthem blue cross PPO Share Plans all cover the same comprehensive package of health care services. The difference is in the deductibles, coinsurance amounts and annual out-of-pocket maximums. Anthem blue cross offers a variety of PPO Share Plans so that you can more precisely choose the best pricing options for you.

Basic PPO and PPO Saver Plans

The Basic PPO and PPO Saver Plans offer in-hospital and surgical coverage with low affordable monthly premiums. These plans are designed to protect against great financial losses due to unexpected illness or injury. Both plans offer limited coverage for professional services; however, for a slightly higher premium, the PPO Saver Plan provides more covered professional services.

HMO Plan Selections

The Anthem blue cross Individual HMO Plan provides extensive coverage with low out-of-pocket costs for covered health care services you received only form HMO Network doctors and hospitals.

The Anthem blue cross HMO Saver Plan provides the same coverage as the Individual HMO Plan, but has a deductible amount for services you receive from hospitals and other health facilities to keep the premiums lower.

Selecting a Plan Type

Use the statements below to help determine that plan type best meets your coverage needs.

• I want more control over my health care and access to any doctor or specialist I choose…………….PPO Plan
• I need a lower monthly premium so I’m willing to pay more for my health care services as they occur through out the year……………….PPO Plan
• I want to pay as little as possible when I see a doctor, so I’m willing to select a specific medical group and physician to coordinate all of my health care needs…………HMO Plan
• I’m willing to pay higher premium up front so that my costs for health care services are lower as they occur throughout the year………..HMO Plan
  

If your family members have varying coverage needs, you can select a different plan (PPO or HMO) for each family member through the Anthem blue cross Family Elect Program. This may help you to design a program that works best for your family overall.