Anthem Blue Cross Gold 80 PPO

These plans are for those who are looking for comprehensive coverage that includes low office visit copayments.

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Anthem Blue Cross Enhanced Gold 80 PPO - 2016
Health Insurance Plans for Individuals and Families

These plans are for those who are looking for comprehensive coverage that includes low office visit copayments with an unlimited number of office visits per calendar year and no charge for annualBlue Cross health insurance physical exams. There are no individual or family deductibles on this plan. Preventive care services, such as routine physical exams and mammogram screenings, are at no charge. This is the one most popular Anthem Blue Cross plan in California and will satisfy your mandated individual health insurance requirement also known as "minimum essential health coverage ".

Plan Name Gold 80 PPO
Medical Deductible None
Drug Benefits Deductible None
Default Medical Coinsurance20%
Default Drug Coinsurance20%
Annual Out-of-Pocket  
Out of Pocket Max for Med and Drug EHB Benefits (Total) Individual: $6,250 Family: $12,500
Emergency Health  
Urgent Care Centers or Facilities $60
Emergency Room Services $250
Emergency Transportation/Ambulance $250
Home Health Care  
Home Health Care Services20%
Hospitalization Services  
Inpatient Physician and Surgical Services20%
Habilitation Services $30
Inpatient Hospital Services (e.g., Hospital Stay) 20%
Skilled Nursing Facility 20%
Substance Abuse Disorder Outpatient Services $30
Substance Abuse Disorder Inpatient Services 20%
Maternity Care  
Delivery and All Inpatient Services for Maternity Care 20%
Prenatal and Postnatal CareNo Charge
Other Services  
Mental/Behavioral Health Inpatient Services 20%
Durable Medical Equipment20%
Hospice ServicesNo Charge
Bariatric Surgery 20%
Mental/Behavioral Health Outpatient Services $30
Acupuncture$30
Rehabilitative Speech Therapy$30
Rehabilitative Occupational and Rehabilitative Physical Therapy$30
Allergy Testing 20%
Chemotherapy 20%
Diabetes Education$30
Dialysis 20%
Infusion Therapy 20%
Prosthetic Devices20%
Radiation 20%
Reconstructive Surgery 20%
Transplant 20%
Treatment for Temporomandibular Joint Disorders 20%
Outpatient Services  
Outpatient Surgery Physician/Surgical Services20%
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)20%
Outpatient Rehabilitation Services $30
Prescription Drug Coverage  
Generic Drugs $15
Non-Preferred Brand Drugs $70
Preferred Brand Drugs $50
Specialty Drugs 20%
Preventative Care  
Well Baby Visits and CareNo Charge
Preventive Care/Screening/ImmunizationNo Charge
Professional Services  
Other Practitioner Office Visit (Nurse, Physician Assistant) $30
Imaging (CT/PET Scans, MRIs) 20%
X-rays and Diagnostic Imaging $50
Specialist Visit $50
Laboratory Outpatient and Professional Services $30
Primary Care Visit to Treat an Injury or Illness $30

Benefits stated above are using in network preferred providers only. Click here for provider information.

 

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