Anthem Blue Cross

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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.

Blue Cross Member Portal

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

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FAQ’s Go Paperless

Website Technical Support 1-866-755-2680

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.

Consumer Resources & Links

Here’s Provider Lists from ALL companies.

Blue Cross SERVICE Phone # (800) 333-0912   or  310.519.1335

Which Blue Cross Anthem Plans are  Grandfathered?

What are Multi State Plans?

Blue Cross Employer Group Plans

Blue Cross Wellness Programs

Specimen Platinum Policy with annotations and bookmarks  2014 

WellPoint, Inc. Code of Conduct

Investor Information & 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

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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. 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.

EPO plans are available in Alpine, Amador, Butte, Calaveras, Colusa, Del Norte, Glenn, Humboldt, Lake, Lassen, Mariposa, Mendocino, Merced, Modoc, Monterey, Nevada, Plumas, San Benito, San Joaquin, San Louis Obispo, Santa Barbara, Santa Clara, Santa Cruz, Shasta, Sierra, Siskiyou, Stanislaus, Sutter, Tehama, Trinity, Tulare, Tuolumne, Ventura and Yuba counties.

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 *

10 comments on “Blue Cross – Anthem

  1. 7 comments on “Provider Lists – Definitions HMO, Tiered – PPO, PPO, EPO”

      • See above for Blue Cross’s definition of EPO Exclusive Provider Organization. Blue Cross is only offering EPO and HMO Health Maintenance Organizations – that definition is above too.

        PPO in San Joaquin County with APTC Subsidies is only offered by Blue Shield – https://individuals.healthreformquotes.com/companies/blue-shield/member-portal/provider-finder/

        Basically, a PPO allows one to go out of network, but the reimbursement will be less. See your summary of benefits or EOC

        schedule of benefits exclusive ppo

        Here’s the 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 https://individuals.healthreformquotes.com/definitions-glossary/

        Reply
      • Call Member Services on the back of your ID Card. Source If you would like a pdf, just let us know your California Zip Code, plan and type of MD you want. Or use the link at the very beginning of this page. Please send us a copy of your ID card to verify network.

        Reply
  2. I’m tired of this back and forth trying to figure out the “websites”.

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

    If this requires a phone call that’s fine.

  3. I don’t like my EOB Explanation of Benefits online, pdf, electronic, etc. Can I get paper copies mailed to me?

  4. I have anthem blue cross, but I’m looking for help inside the plan.

    It looks like not what you do, but do you have any suggestions?

  5. Steve,

    Thanks for taking such good care of us.

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

    Your loyal client,

    Mike

  6. 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

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