Smart Sense Plus Insurance

Smart Sense Plus Health Insurance Plans from Anthem Blue Cross are a great combination of affordability and coverage. Take a couple minutes to review all of the features, then either get a quote or apply online now.

SmartSense Plus Health Insurance Plans

The Individual PPO SmartSense Plus health insurance plans offered by Anthem Blue Cross are a popular choice that offer mid range pricing. These plans are not the most expensive and are not the least expensive. They have some limitations and overall, rank quite well with conservative, price sensitive shoppers looking for value.

Should I Choose SmartSense Plus?

The SmartSense Plus product line offers a total of 8 plans for individuals. You have 4 deductibleBlue Cross health insurance options as well as 2 prescription drug benefit options to choose from. This allows you to tailor a plan to meet your specific needs.

The annual deductible options are $1,000, $2,000, $3,500 and $5,000. Remember, the higher the annual deductible you choose, the lower your monthly payment will be.

You will have the choice of either an Upgrade or Standard prescription drug benefit option. The upgraded drug benefit (as noted in the plan name as "Upgrade RX") includes both brand and generic drug coverage. Understand that the upgraded prescription drug benefit offers brand drug coverage subject to a separate $500 annual brand drug deductible. The standard drug benefit (as noted in the plan name as "Standard RX") includes both brand and generic drug coverage. However the standard prescription drug benefit offers brand drug coverage subject to a $7,500 annual brand drug deductible. Most individuals won't come close to meeting this brand drug deductible so know that going in. Consult the drug formulary listing to see how your specific drug will be covered before you apply.

If you are looking for this plan to include maternity coverage, look elsewhere. At the present time, maternity is not covered under this plan however, we are in the midst of healthcare reform so maternity could be covered by this plan in the future. Contact us for more information.

Like all Anthem Blue Cross PPO plans, the SmartSense Plus plans include "No Charge" preventive benefits such as a routine annual physical exam. In general, this includes an annual gynecological exam, mammogram or even a PSA test to name a few. These are no charge visits however it is all dependent upon how the doctors office processes the claim. If you come in with a symptom in addition to the annual physical exam, you may be charged for additional professional services including your office visit copayment. The visit in that sense becomes diagnostic in nature so other charges may apply. What is considered as a "No Charge" preventive benefit is defined by the Health and Human Services Department. Ask us for a complete listing.

This plan includes a limitation to the number of doctor office visits per calendar year. You will be limited to 3 office visits per calendar year at a $30 copayment (not subject to your annual deductible) and if you need more than the 3 visits during that same calendar year, the annual deductible will apply.

The SmartSense Plus plans all have an out of pocket maximum of $3,500. This, in addition to the plan annual deductible, will allow you to determine the maximum amount that you could pay in one calendar year if something catastrophic (like hospitalization) were to happen to you.

The coinsurance percentage for the SmartSense Plus plans is at 30%. What this means is that after you have satisfied a plans annual deductible you will be billed at this percentage (based on a negotiated rate) until you reach the plans out of pocket maximum. Once the out of pocket maximum has been met, most services will be covered at 100% for the duration of that calendar year.

If you're looking for comprehensive, mid range priced plans that offer benefit options to tailor your specific needs, look no further than SmartSense Plus.

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