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California Health Insurance > Anthem Blue Cross > Premier Plus
Anthem Blue Cross Premier Plus
The Anthem Blue Cross Premier Plus plan is a relatively rich benefit individual PPO plan. It has unlimited doctor office visits; brand medication after only a $500 Rx deductible. These plans have a wide selection of deductibles. All of the Premier deductibles are added to the Out of Pocket Maximum of $4500, so it is easy to understand these plans. On the down side, because the benefits are richer, the monthly premium is higher than on other California individual and family health insurance plans.
Key Benefits (as of April 2011)
- Deductibles are: $1000, $1500, $2500, $3500, $5000, $6000
- Out of Pocket max - $4500 (in addition to the deductible)
- Coinsurance - 25% after deductible has been met
- Lifetime max - Unlimited
Covered Service before the deductible
- Office Visit - $30 Copay, Specialist $50 Copay
- Preventive Care - No Charge
- (Includes all nationally recommended preventive services including Pap testing, mammograms, PSA screening, immunizations, well-child care and more)
Covered Service after deductible has been met
- Professional and Diagnostic - 25% Coinsurance
- (X-ray, lab, anesthesia, surgeon, etc.)
- Emergency Room Services - 25% Coinsurance
- Outpatient Services - 25% Coinsurance
- (Without overnight hospital / facility stays)
- Inpatient Services - 25% Coinsurance
- (Overnight hospital / facility stays)
Services Not Covered
Prescription Drug Coverage
- Tier 1 (generic drugs) $15 Copay
- Tier 2 (brand name drugs) $40 Copay after $500 deductible
- Tier 3 (non formulary drugs) $60 Copay after $500 deductible
- Specialty drugs 25% coinsurance up to a $2500 annual out-of-pocket maximum, in addition to the $500 deductible.
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