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CoreGuard PPO
Anthem Blue Cross
Don't Live in California?
Anthem
Colorado		 Anthem
Kentucky		 Anthem
Indiana 		Anthem
Nevada		 Anthem
Ohio

CoreGuard from Anthem Blue Cross...

Quick QuoteSmart Sense PPO PlansAnthem Blue Cross brings to market a new plan that fits the way you live. Whether you're self-employed, need coverage for your family, just left group coverage, or your job doesn't provide it, Anthem Blue Cross offers dependable individual health care plans that save you time and make sense for the way you live.

Why do you need health coverage?

These days, a single day in the hospital can cost thousands of dollars. The financial risk you take without health coverage just isn't worth it. Not only does health coverage help you stay healthy, it also gives you added security, because you know you're protected against the high cost of unexpected medical bills.

Why CoreGuard makes sense...

If you're looking for a simple plan design with some fo Anthem's lowest rates, CoreGuard could be the plan that's right for you. CoreGuard offeres a wide range of deductibles (from $750 - $10,000) and higher cost-sharing helps lower your monthly premiums. CoreGuard offers up to $4 million per member in lifetime benefits.

CoreGuard Preventive Care...

With CoreGuard, certain basic preventive care screenings are coverage after you meet your deductible. You also have the option of going to a HealthCheck Center for annual preventive screenings without first needing to meet your deductible.

Prescription Drug Coverage... The cost of prescription drugs can be staggering so CoreGuard includes prescription drug coverage to help you manage those costs:

bulletDrug Formulary: This is a special list of prescription drugs the CoreGuard plan covers. Anthem has negotiated lower prices on these formulary drugs, so you'll save when your doctor prescribes from the Plan Formulary posted at www.wellpointnextrx.com/Formulary1.

bulletTier 1:These drugs have the lowest copay and include low-cost or preferred medications. This tier includes lower cost generic and brand-name drugs.

bulletTier 2: These drugs have a higher copay than those in Tier 1 and include preferred medications that are generally moderate in cost. They include higher cost generic and brand-name drugs.

bulletSpecialty: These are typically high-cost, scientifically engineered drugs and are paid at a coinsurance level instead of copay.
CoreGuard Plan Highlights
This plan can be ideal for individuals who want affordable protection against significant medical expenses.

Features:

A simple plan design with some of their lowest monthly rates
arrow Higher percentage of member cost sharing in exchange for lower premiums
arrow Once the deductible is met, Anthem shares 50% of the costs at their negotiated rates up to $3,500, then they cover the rest
arrow Coverage for prescription drugs

Things you should know:

1) This plan has its own Drug Formulary
2) Maternity benefits are not included with this plan

Anthem Blue Cross Medicare SupplementNetwork Coverage...

With Anthem's extensive network of providers, chances are that your doctor is already part of their network. And all network providers have lower rates for their members. You'll have access to these lower rates (discounts) before and after meeting your deductible. The plans from Anthem Blue Cross also offer out-of-network coverage but you'll pay less when you choose an in-network provider. To view the list of network providers Click Here.

How to Enroll

Enrolling is easy. Submit your application online by clicking the "APPLY NOW" link below. If you have questions and would like an agent to contact you prior to applying then click on the Agent Assist link to the right or call us at 619.435.6700.

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)
  • Have questions? Then give us a call or complete the SALES ASSISTANCE form to the right. We will call you.
  • Applying is easy - simply complete the application process online from the comfort of your home or office. Ready to Apply? Click Here...
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left corner Anthem Blue Cross CoreGuard PPO
Benefit Guide for California		 right corner
Calendar Year Deductible
Your Choices

Individual (In-network & Out-of-Network)
$750
$1,500
$2,500
$3,500
$5,000
$7,500
$10,000
Family (In-network & Out-of-Network)
$1,550
$3,000
$2,500
$3,500
$5,000
$7,500
$10,000
In-Network Coinsurance 50%
Out-of-Pocket Maximum
Add Your Chosen Deductible to the Amount Below
Individual
In-network
Out-of-Network
$3,500
$3,500
$3,500
$3,500
$3,500
$3,500
$0
$7,500
$7,500
$7,500
$7,500
$7,500
$7,500
$7,500
Family
In-network
Out-of-Network
$7,000
$7,000
$7,000
$7,000
$7,000
$7,000
$0
$15,000
$15,000
$15,000
$15,000
$15,000
$15,000
$15,000
How family deductibles and family out-of-pocket maximums work Each family member has an individual deductible and out-of-pocket maximum. Once one family member reaches their individual deductible or out-of-pocket maximum, the remaining amount of the family deductible or out-of-pocket maximum needs to be met by one or more other family members.
Plan Lifetime Maximum Plan pays up to $4 million per member for in-network and out-of-network services combined.
Covered Services Your Share of Costs (after deductible, unless waived)
Doctor's Office Visits In-Network 50% Coinsurance (with $750, $1,500, $2,500, $3,500, $5,000, $7,500)
0% Coinsurance (with $10,000)
Out-of-Network 70% Coinsurance (with $750, $1,500, $2,500, $3,500, $5,000, $7,500)
30% Coinsurance (with $10,000)
Professional/Diagnostic Services
(X-ray, lab, anesthesia, surgeon, etc.)		 In-Network 50% Coinsurance (with $750, $1,500, $2,500, $3,500, $5,000, $7,500)
0% Coinsurance (with $10,000)
Out-of-Network 70% Coinsurance (with $750, $1,500, $2,500, $3,500, $5,000, $7,500)
30% Coinsurance (with $10,000)
Inpatient Services
(overnight hospital/facility stays)		 In-Network 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)
Out-of-Network 70% Coinsurance PLUS $500 Facility Copay per day up to the first 3 days (with $750, $1,500, $2,500)
70% Coinsurance (with $3,500, $5,000, $7,500)
30% Coinsurance (with $10,000)
Outpatient Services
(without overnight hospital/facility stays)		 In-Network 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)
Out-of-Network 70% Coinsurance PLUS $500 Facility Copay per day up to the first 3 days (with $750, $1,500, $2,500)
70% Coinsurance (with $3,500, $5,000, $7,500)
30% Coinsurance (with $10,000)
Emergency Room Services In-Network or Out-of-Network:
50% Coinsurance (with $750, $1500, $2500, $3500, $5000, $7500) or 0% Coinsurance (with $10000)
Preventive Care Services In-Network Adults and children ages 7-17: Routine Mammogram, PAP and PSA tests: 50% Coinsurance (or 0% Coinsurance with $10,000 plan)
HealthCheck Centers: $25 Basic/ $75 Premium, deductible waived
Out-of-Network Adults and children ages 7-17: Routine Mammogram, PAP and PSA tests: 70% Coinsurance (or 30% Coinsurance with $10,000 plan)
Maternity Not Covered
Additional Covered Benefits Includes but not limited to: Ambulance, Chiropractic Services, Home Health Care, Mental Health,
Physical / Occupational Therapy, Urgent Care
Prescription Drug Coverage  
Retail and Mail Order Drugs on the Plan Formulary In-Network Tier 1 (Lower cost Generic & Brand-name drugs): $15 Copay
$2,000 annual deductible per member applied before the following:
- Tier 2 (HIgher cost Generic & Brand-name drugs): $35 Copay
- Specialty: 25% Coinsurance up to a $2,500 Annual Out-of-Pocket Maximum (the most you'll have to pay), in-network only and in addition to $2,000 annual deductible
Non-formulary drugs: Not covered, discounts apply
Out-of-Network Not Covered
Consider Other Anthem Blue Cross PPO Plan Links
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