Anthem Blue Cross
Individual & Family Health Insurance Plans
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.
- 2022 - All Plans - 6 languages
- Product Guide Direct - Not Covered CA
- Plan Matrix
- Steve's VIDEO Introduction to the brochure
- Anthem VIDEO on subsidies and options
- 2022 Covered CA
- Product Guide
- Silver HMO EOC Evidence of Coverage-Plain English VERY informative!
- Anthem.com/ca/pharmacy – Formulary information
- Direct Paper Application - ONLINE is better & faster
- Covered CA - Online Application through Quotit
- BROKER ONLY https://anthembrokerhub.com/
Manage claims, your health, preventative benefits, find doctors, plan details, benefits, refill rx, health assessment and compare costs
- Login In or Register
- Bank Draft Form
- FAQ’s Go Paperless
- Q: Do I have to go paperless?
- A. Not at all. The choice to go paperless or stick with paper claim summaries is up to the subscriber. But going paperless is a great option.
Here’s a 2 page pdf on how to read Blue Cross’s EOB
More information on Claims Payment Policies & Practices
Here’s a Blue Cross subsidiary’s answer!
How do I get a paper EOB?
Answer: You may contact Member Services at the telephone number listed on your ID card to obtain a paper copy of an EOB. Carefirst
If you appoint us as your broker, no extra charge, we can do this for you.
- Claim Forms
- 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
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.
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 states. Excerpt 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
Dental Plans cover things like Root Canals, Dentures, Braces, routine cleaning.
Picture of Oral Health
- Dental care reduces likelihood of hospitalization for people with diabetes or coronary artery disease Medical Press 5.6.2022
- The 2022 State of America’s Oral Health and Wellness Report Commissioned by Delta Dental Plans Association
- What drives buyers of individual Delta Dental plans?
- 77 Million Adults Do Not Have Dental Insurance
- What dental Insurance... should I buy???
VIDEO the dentist attempts to give you some guidance about things to consider before buying a dental insurance plan, finance plans available, negotiating with your dentist
- Sacramento Truck driver sudden dealth from tooth infection Sacramento Bee 1.31.2017
- Health Savings Accounts?
- Video - how bad sugary drinks are for you
Provider Lists – Definitions
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
- Network Map Individual & Family Plans
- What plans do major providers accept?
- Cedar’s Sinai,
- Health Care Partners – Optum,
- THIPA Torrance Memorial IPA
Blue Cross Removes UC Hospitals From EPO Health Plans
UC Davis Medical Center, UC San Francisco Medical Center and Children’s Hospital, along with Benioff Children’s Hospital in Oakland are no longer part of their Pathway EPO network as January 1, 2022 Learn More - Insure Me Kevin.com
- Anthem Blue Cross Provider List Definitions Individual Plans
- Enroll with Blue Cross Anthem
- What to do when you receive a doctor bill VIDEO
- VIDEO When you're looking for health insurance in California, consider the quality of care provided by Anthem Blue Cross. The Anthem team knows the needs of growing families and offers an array of plans that offer affordable coverage for members of all ages.
- VIDEO What do do when you get a doctor's bill
- Live Health ONLINE - Tele Med with therapist VIDEO
- SYDNEY Overview VIDEO
- In & Out of Network - What's a network? HN Video
- Steve helps you find PCP VIDEO
Anthem Blue Cross #Medi-Cal Website
800 227 3238
- Medical Services
- CMSP (County Medical Services Program)
- GA/GR (General Assistance and General Relief )
- Cash Aid
- County Medical Services Program (CMSP),
- Food Assistance - Cal Fresh (formerly known as Food Stamps)
- How to use Eat Fresh.org VIDEO
- Cooking & Nutrition
- California Work Opportunity and Responsibility to Kids (CalWORKs) or check their other website
- Required Reporting
- Job Skills
- You Tube Channel Videos
- Medi Cal Explained CHCF
- More explanation
- California Advancing and Innovating Medi-Cal (CalAIM) is a long-term commitment to transform and strengthen Medi-Cal, offering Californians a more equitable, coordinated, and person-centered approach to maximizing their health and life trajectory.
- Medi Cal Contact Information
- Our Webpages on
- Medi Cal Benefits
- Denti Cal
- Medi-Cal – MAGI Income Eligibility Criteria
- Aged and Disabled Federal Poverty Level Program
- Contact Info – Complex Questions – Reference Materials Medi-Cal
- Dual Coverage? Medi Cal, Employer Group, Individual, Cal Medi Connect & Medicare
- Full Scope Medi-Cal – Benefits & Coverages
- Transitions from Medi-Cal to get Covered CA
BIC Benefits Identification Card
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.
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.
- Contract Code Plan description
- 1518 Basic 1000
- 7900 Basic 1000
PE25 Basic 1000
PE26 Basic 1000
- 7900 Basic 1000
- Z165 SmartSense 2500 Full RX
- Z166 SmartSense 2500 Full RX email dated 6.23.2022 *
- Anthem Blue Cross will let you know your options sample letter for selecting a new plan during
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.