California Health Insurance > Anthem Blue Cross > CoreGuard Plus

Anthem Blue Cross CoreGuard Plus

Anthem Blue Cross of California Core Guard Plus plan is popular because the monthly premium is so low. There are seven different deductibles to select from. Most services (except preventative) are covered only after the person enrolled has paid the full deductible amount. The medical deductible does not apply to prescription medicine. The Core Guard Plus plans offer generic Rx for only a $15 copayment. However, if you want brand medication, hold onto your wallet - there is a $7,500 brand name prescription medicine deductible on these plans. Remember the deductible is for the calendar year only (January 1 - December 31). So, don’t get sick at the end of the year or you will have to pay deductibles for both years.

To summarize, you pay very little on a monthly basis for the Core Guard Plus plans from Anthem Blue Cross of California, but (and this is very important to understand) you will pay A LOT to the doctors, hospitals and pharmaceutical companies if you do get really sick or injured.

• Deductible - $750, $1500, $2500, $3500, $5000, $7500, $10,000
  
  
• Out of Pocket max - $3500 (in addition to the deductible; does not apply to the $10,000 deductible plan)
  
  
• Coinsurance - 50% after deductible has been met
  
  
•                    0% for the $10,000 deductible plan
  
  
• Lifetime max - Unlimited
  

• Preventive Care - No Charge
• (Includes all nationally recommended preventive services including Pap testing, mammograms, PSA screening, immunizations, well-child care and more)

• Office Visit - 50% Coinsurance (or 0% Coinsurance with $10,000 plan)
  
  
• Professional and Diagnostic - 50% Coinsurance (or 0% Coinsurance with $10,000 plan)
  
• (X-ray, lab, anesthesia, surgeon, etc.)
  
  
• Emergency Room Services - 50% Coinsurance (or 0% Coinsurance with $10,000 plan)
  
  
• Outpatient Services - 50% Coinsurance PLUS $200 Facility Copay per admission (with $750, $1,500, $2,500)
  
•                          50% Coinsurance (with ($3,500, $5,000, $7,500)
  
•                          0% Coinsurance with $10,000 plan
  
  
• Inpatient Services - 50% Coinsurance PLUS $500 Facility Copay per day up to the first 3 days (with $750, $1,500, $2,500)
  
•                          50% Coinsurance (with ($3,500, $5,000, $7,500)
  
•                          0% Coinsurance with $10,000 plan
  

• Maternity Care

• Tier 1 (generic drugs) $15 Copay
  
• Tier 2 (brand name drugs) $40 Copay after $7,500 deductible
  
• Tier 3 (non formulary drugs) $60 Copay after $7,500 deductible
  
• Specialty drugs 25% coinsurance up to a $2,500 annual out-of-pocket maximum, in addition to the $7,500 deductible.
  

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