This is a PPO plan that allows you to use preferred providers. Both Medicare-eligible and non-Medicare-eligible members can join this plan.
- This plan has a California-based preferred provider network of physicians and hospitals that have negotiated with Anthem Blue Cross to provide discounted services to participants.
- You decide at the time you need healthcare services whether to see a network provider or a non-network provider.
- If you see a Prudent Buyer physician, you may see any physician you choose. The plan pays 80 percent after deductible has been met.
- If you see a non-Prudent Buyer physician, the plan pays 70 percent after the deductible has been met.
- Deductibles: individual $100; family $200
- There are no annual benefit maximum amounts
- Lifetime Maximum Benefits: $1,000,000. If you meet the lifetime maximum, you will need to move out of Anthem Blue Cross and into a LACERA-administered plan that is available in your area. LACERA's Retiree Healthcare Division will coordinate the transition. If there are no other plans available, you will be disenrolled.
- Prescription Benefit Manager: Ingenio Rx. You can fill home delivery prescriptions through the IngenioRx Home Delivery Pharmacy using the phone number listed on the back of your ID card. For questions regarding your ID card, please contact Anthem Blue Cross.
- ConditionCare Disease Management Program