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Anthem Blue Cross Life & Health Insurance Company
Individual & Family Health Plans
The 3500 Deductible PPO

Timothy Jennings
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If you are internested in a HSA Compatible Product Click Here for the Blue Cross PPO 3500 Plan HSA Compatibile Plan
The 3500 Deductible PPO Plan

Quick QuoteBlue Cross 3500 Deductible BrochureFrom Anthem BC Life & Health Insurance Company (Blue Cross) features on of their lowest out-of-pocket maximums for a PPO Plan: $3,500 (which satisfied for participating providers once the $3,500 annual deductible is met). And here's more good news about this easy-to-undertand plan: After meeeting this deductible, you pay $0 for doctors' office visits, $0 for professional services and $0 for hospital inpatient/outpatient services. Certain annual screenings for women and men are also $0 after your deductible. What could be simpler? This plan does not include maternity coverage.

For prescription drugs, you pay just a $10 copay for generic drugs and a $30 copay for brand-name drugs (after you meet the $500 brand-name deductible). And the 3500 Deductible PPO's monthly premiums are amoung their lowest.

PPO 3500 Deductible Plan includes:

  • Access to over 50,000 California network doctors and specialists and over 400 hospitals - so you're covered just about anywhere
  • Significant savings for you - because they have negotiated lower fees with our network doctors and hospitals, your share of costs is less while meeting your deductible
  • No charge for most covered services after meeting your annual deductible
  • Out-of-state coverage that allows you to use your plan's benefits when traveling

Lumenos Health PlansProtect Your Health and Financial Future

Even if you're healthy, you could be caught off-guard by an unexpected illness, injury or serious accident. Medical care can quickly add up to staggering financial loss. The PPO 3500 Deductible Plan can help limit your out-of-pocket expenses, protect your assets and safeguard your future earnings

You can get even more value from your health plan by taking advantage of programs and services to help you stay healthy - such as preventive care screenings, health and wellness programs, 24-hour information by phone from registered nurses, and health living resources.

So who was the PPO 3500 Deductible designed for?

  • Those wanting coverage that is simple to use - just meet your deductible and then pay $0 for most covered services
  • Individuals who don't want maternity coverage
  • Self-employed Individuals
  • Empty nesters and early retirees
  • Self-employed individuals
How to Enroll

Enrolling is easy. Submit your application online by clicking "APPLY NOW". If you still have questions and would like an agent to contact you prior to applying then complete the Agent Assist link to the right or call us at 619.435.6700.
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To enroll, you must be:

  • Age 64 3/4 or younger
  • A permanent legal resident of California
  • A U.S. resident for at least the lst 3 months
  • The applicant's spouse or domestic partner, age 64 3/4 or younger
  • The applicant's children (under 19 years of age), or the children (under 19 years of age) of the applicant's enrolling spouse or qualified partner or qualified domestic partner;
  • The applicant's unmarried dependent children between the ages of 19 through 22 ("dependent" as defined by the Internal Revenue Service)

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left corner Anthem 3500 PPO Deductible Benefit Matrix right corner
3500 Deductible PPO Monthly Rates
Benefit
In-Network
Out-of-Network
Annual Deductible $3,500 per member
(Once 2 members each reach the deductible, the deductible is satisfied for the entire family)
Lifetime Maximum $5,000,000 per member
Annual Out-of-Pocket Maximum
(includes deductible)
Participating & non-participating provider covered services apply
This is satisfied once the
annual deductible is met 		$10,000 per member (Once 2 members each reach the maximum, the maximum is satisfied for the entire family)
Doctors' Office Visits $0 after deductible 50% of negotiated fee plus all excess charges (after deductible )
Professional Services
(X-ray, lab, anesthesia, surgeon, etc.) 		$0 after deductible 50% of negotiated fee plus excess charges (after deductible)
Hospital Inpatient
(Overnight Hospital Stays)		 $0 after deductible All Charges except $650 per day
Hospital Outpatient
(If You Don't Stay Overnight) 		$0 after deductible All Charges except $380 per day
Emergency Room Services $0 after deductible All charges in excess of customary and reasonable fees (after deductible)
Maternity Not covered Not covered
Preventive Care Routine mammogram, Pap and PSA tests4: $0 after deductible

HealthyCheckSM Centers5: $25/$75 copay for basic/premium screening (deductible waived)

Well Baby and Well Child (through age 6): $0 after deductible

Routine mammogram, Pap and PSA tests4: 50% of negotiated fee plus all excess charges (after deductible)

Well Baby and Well Child (through age 6): 50% of negotieated fee plus all excess charges (after deductible)

Ambulance $0 after deductible 50% of negotiated fee plus excess charges (after deductible)
Physical & Occupational Therapy; Chiropractic Services $0 after deductible All charges except $25 per visit, (after deductible)
Accupunture/Accupressure All Charges except $25 per visit, up to 24 visits per year (after deductible)
Prescription Drugs
(Blue Cross Formulary7)
Amounts shown are for each 30-day retail or in-network mail order supply 		$10 copay genric; $30 copay brand-name8 (after $500 brand name prescription drug deductible), 30% of negotiated fee for self administered injectables, except insulin (after annual deductible) 50% of drug limited fee schedule and all excess charges plus the copay / coinsurance as stated for in-network benfits (after deductible)
Other Blue Cross PPO Plan Links
P O Box 6374 Jackson Hole, WY 83002-6374
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