Blue Cross 2015 Brochure - Direct

Anthem Blue Cross
Individual & Family Health Insurance Plans

Anthem #Blue Cross

We are Blue Cross – Anthem ♦ Authorized Agents  Broker # GFKGQSJSRZ  and are happy to help you get covered in CA at no extra charge to you.  Blue Cross pays us to help you find their best plan that fits your needs.    Here are a few of the many benefits that an agent/broker can provide to the public.  

The BEST way to get the most current specific brochures and rates for each plan  is to use the button below or logo above and get quotes.

ABC_Authorized_Agent_black_blue

NEW Name:  Elevance Health

Blue Cross #MemberPortal

Blue Cross Member Website - Interactive Guided Tour

Manage claims, your health, preventative benefits, find doctors, plan details, benefits, refill rx, health assessment and compare costs

Contact #'s

  • Check the back of your ID card
  • Website Technical Support 1-866-755-2680
  • 800-928-6201-Part D Customer Service Phone number
  • 800 333 3883-Med Supp Customer Service phone number
  • Medicare Advantage Member Services
    • (1)  HMO Customer Service  888-230-7338
    • (2)  HMO DSNP Customer Service  844-469-6831
    • (3)  PPO Customer Service   877-811-3107
    • (4)  ESRD PPO SNP Customer Service 844-648-9540

Sydney App for  iPhone and Android  

sydney app i phone

  • Find care and check costs: It’s easy to search for doctors, dentists, hospitals, labs and other providers in your plan. You can search by name, location and type of care. You can even filter by gender or languages spoken, then check costs before you go. This helps you find what’s best for you.
  • View claims: With one click, you can check claims. That means you can spend more time focused on your health and less on managing your health benefits.
  • View and use digital ID cards: You can always have your most current ID card handy. And you can use it just like a paper one when you visit the doctor, dentist, pay for care and more.
  • See all benefits: Sydney shows you essential information at a glance, whether that’s an overview of your plan, health reminders or suggestions for wellness programs. You also can find your deductible, copay and share of costs.
     
  • Use the interactive chat feature and get answers quickly: Simply type your questions in the app and get answers quickly. Plus, Sydney can suggest resources to help you understand your benefits, improve your health and save money.
     
  • Check My Family Health Records (myFHR): myFHR gives you easy access to your health data, including health history and electronic medical records, all in one place. Availability is based on your plan.

Anthem Blue Cross
COVID Resource Center 

Coverage of COVID 19
Rev 8.2020

11.13.2020 Update  

Anthem Blue Cross FAQ COVID 19

10% premium discount for August 2020

More COVID FAQ's

Email us, if any links require a password

Investor & Financial Strength

What is a (Blue Cross or Shield) #Multi State Plan under the Affordable Care Act?

 

The Multi-State Plan (MSP) Program, established under the Affordable Care Act, directs OPM [Federal Office of Personnel Management*] to contract with private health insurers in each State to offer high-quality, affordable health insurance options called Multi-State Plans OPM.Gov      FAQ’s

Multi-State Plans are overseen by the U.S. Office of Personnel Management (OPM) and are similar to the other Qualified Health Plan products offered on the exchanges. Generally, all of the same requirements that apply to other products also apply to these Multi-State Plan products. The name “Multi-State Plan” does NOT mean that consumers have health plan coverage for non-urgent care in multiple statesExcerpt from Agent Guide

OPM’s claim to fame appears to be that they have 50 years of experience running the Federal Employees Health Benefits (FEHB) Program.  I do not see that the Multi State Programs have anything extra than the others.  See also Minimum Essential Benefits and Medical Mandatory Loss Ratio’s

Get FREE Quotes in CA

Consumer Resources & Links

Anthem Blue Cross California Individual & Family
#Dental Net 3000 d, Prime, Blue  Plans

Dental Plans cover things like Root Canals, Dentures, Braces, routine cleaning.

Blue Cross Anthem Dental & Vision Brochure

Blue Cross Brochure Dental

#Importance of Dental Coverage 
Dental & General Health

Insurance 101?

We suggest that you check out Life Insurance, Disability, Long Term Care and Retirement as these risks may cause much more financial devastating to your budget than dental bills.

Picture of Oral Health 

Why you need Group Dental Coverage

 

Steve on buying, shopping and best use of premium dollars
Dental Insurance VIDEO

steve's video on dental coverage

MORE VIDEOS

Our other pages on
Dental Coverage

We don't put a lot of effort into selling dental coverage.  Generally it's a wash on paying premiums vs getting back claims payments.  Unless it's employer group.  Then the premiums are tax deductible under IRS  Section 106.

Here's more information on how we feel about dental.  Here's our page on implants, where we get lots of inquires, but few sales.  Most people only seem to want dental coverage, after they've been told they need a lot of dental work.  Not profitable for Insurance Companies.  See our other pages for details & explanations.   See our page on Medical Loss Ratio.  Insurance Companies need to take in $1 to pay 80c in claims.

 

Medicare Plans

Individual & Family Plans

Dental For Everyone,
has an excellent  website with full brochures, Instant online quoting and enrollment

 

One of our colleagues on how Dental for Everyone Works..

 

Employer Group Plans

Provider Lists – Definitions
HMO, EPO

#Networks 2021

WHAT SHOULD I KNOW ABOUT MY NETWORK?

Exclusive provider organization (EPO):

With our EPO plans, you’ll be able to see any in network doctor, no PCP required. Email dated 1.7.2022 9:32 AM *  It’s a good idea to have a primary care doctor to coordinate your care, so we’ll pick one close to your home and let you know your assignment in the beginning of the year. You don’t need to see this doctor for services or referrals, and you can change your assigned primary care doctor at any time.

EPO plans don’t offer out of network benefits, except for emergency and urgent care, ambulance services or when a service is pre approved. If you see a doctor not in your plan for any other reason, you’ll have to pay 100% out of pocket.

Health maintenance organization (HMO):

With an HMO, you have to choose a primary care doctor to manage your care needs — including getting referrals to see other network doctors. HMOs don’t offer out of network benefits, except for emergency and urgent care or when a service is pre approved. If you see a doctor not in your plan for any other reason, you’ll have to pay 100% out of pocket HMO plans are available in Fresno, Kings, Los Angeles, Madera, Riverside and San Bernardino counties  Brochure * 2021 Brochure *

Basically, a PPO allows  one to go out of network, but the reimbursement will be less. See your summary of benefits or EOC   Evidence of Coverage for Blue Shield PPO Silver 70

Participating (Participating Provider)

A provider who participates in this plan’s network and contracts with Blue Shield to accept Blue Shield’s payment, plus any applicable Member Cost Share, as payment in full for Covered Services. Also referred to as an in-network provider.

Blue Shield PPO Brochure

Preferred Provider Organization (PPO)

A type of health benefit plan designed to give enrollees incentives to use health care providers designated as “preferred providers”, but that also give substantial coverage for services received from other health care providers.

PPO plans can also be distinguished from HMO plans by the ability of PPO members to see any specialty physician without referral from a PCP, although some HMOs with a POS feature may allow this as well. See also HMO See our HMO, EPO & PPO page

Definitions & Glossary

#Find a Anthem Blue Cross
Doctor, Physician, Dentist Hospital and other Providers
 

Anthem Blue Cross provider doctor search

 

#My Medi-Cal 
How to get the Health Care
You Need

24 pages

Smart Phones - try turning sideways to view pdf better
My medi cal explanation of medi cal

FAQ’s “Provider Lists – Definitions HMO, Tiered – PPO, PPO, EPO”

In California Blue Cross and Blue Shield are two totally different and separate companies.  See our webpages…

 

Broker ONLY

SBC’s available on the producer tool box. Once you log on, go to TOOLS & RESOURCES – ONLINE RESOURCES  and under Resources on the left it has the link . Full EOC’S

If you want to look at a particular member’s EOC, you go the clients account.  You select DOCUMENTS and below is the screen you will see. Select the Coverage Certificate –MED and that is the EOC.

blue cross broker portal

Anthem Blue Cross Grandfathered PLans being #discontinued! 

 

Anthem Blue Cross will be discontinuing the  grandfathered plans below, the rest of their plans are good. The last day of coverage for these plans is December 31, 2022.

Blue Cross doesn't have any downgrade options - that is, the ability to just select a different grandfathered plan.  You'll have to

Affected members will still receive rate action notifications through the end of the year.

9 comments on “Blue Cross – Anthem Individual

  1. Can IBM retirees stay on the same Anthem Blue Cross Plan F insurance instead of having to get United Healthcare Advantage Plan? Thank you.

  2. Am I financially better if I want to change to Anthem blue cross PPO at the same level of coverage I currently have. [Gold]

  3. Steve,

    Thanks for taking such good care of us.

    You are really a great person in a sea of confusion .

    Your loyal client,

    Mike

  4. 1 I was interested in an anthem blue cross d [direct – not through Covered CA] platinum plan….

    2 I have a cancer and

    3 I did not have insurance previous. ….

    4 is there a waiting period for my treatments

    • 1. Great. See above links to get quotes.

      2. I’m sorry to hear that. Hope you recover soon. Under Health Care Reform, there are no medical history questions. Section 2701.

      3. That doesn’t matter either.

      4. No. If you enroll by the 29th at 4 PM you can have coverage starting March 1, 2016. – While the official deadline is the 31st, we are not planning to work the weekend. Mental Health is also an essential benefit.

Leave a Reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.