spacer
Complete Application

Anthem Blue Cross Logo
Anthem Blue Cross - California
SmartSense PPO Plans

Timothy Jennings

Its All About the Bottom Line....

Quick QuoteBasic PPO Plans Anthem BC Life & Health Insurance Company brings you the new SmartSense PPO plan for individuals. SmartSense offers solid protection that covers the essentials of full medical at one of thier lowest rates. Members can choose dedictibles from as low as $500 and up to $5,000 with premium levels that work for you making it even more budget-friendly.

SmartSense is a smart choice for you if this is what they want:

  • Low monthly rates
  • Full medical benefits
  • Four annual deductible options, ranging from $500 to $5,000
  • Immediate benefits for first three visits to a doctor
  • Choice of comprehensive or generic only prescription drug benefits
  • Access to our existing California PPO network
  • No maternity benefits
  • Up to $7,000,000 per member in lifetime benefits

What’s Different About SmartSense

  • Embedded (family) deductibles make it easier for families to satisfy deductible requirement:
    • Once any family member meets their single deductible, their deductible is satisfied
    • After one family member’s single deductible is satisfied, the family deductible can be met by one or more family members
  • Fourth quarter carry-over deductible feature
  • Separate in-network and out-of-network out-of-pocket maximums
  • No $500 per admittance charge for inpatient services or outpatient services related to surgery or infusion therapy at a participating hospital
  • Healthy Check and coverage for acupuncture and acupressure services are not included
  • Monthly RatesYour clients’ annual out-of-pocket costs for brand name prescriptions are capped for their protection
  • SmartSense contract codes are based on:
    • Deductible
    • Rx selection
    • 1 member vs. 2+ members
    • Each plan has a different contract code

How to Enroll

Enrolling is easy. Submit your application online by clicking the "APPLY NOW". 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)
Sales Assistance
First Name
Last Name
Phone
Email
Comments

Travel InsurancePlanning a Trip?
Receive an instant quote from Individualhealth.com. Click on the banner to the right and get your travel insurance quote now

left corner Anthem Blue Cross SmartSense PPO
(To View Rates Popups must be enabled in your browser)
right corner
SmartSense PPO Monthly Rates
Benefit
In-Network
(Receive negotiated savings)
Out-of-Network
(Pay higher costs)
Lifetime Maximum
(Combined for In-Network & Out-of-Network)
Health plan pays up to $7,000,000 per member
Annual Deductible Choices
(Not combined for In-Network & Out-of-Network)
Single Member: $500 / $1,500 / $2,500 / $5,000
Family Member: $1,000 / $3,000 / $5,000 / $10,000
(Once 2 members each reach the deductible, the deductible is satisfied for the entire family.)
Single Member: $5,000
Family Maximum: $10,000
Annual Out-of-Pocket Maximum
(in addition to deductible)
(Combined for In-Network & Out-of-Network)

$3,500/$5,000 per member, only hospital costs apply
(Once 2 members each reach the maximum, the maximum is satisfied for the entire family)
Doctors' Office Visits $30 copay for first three visits per member per year (deductible waived); after three visits and once deductible is met, then 30% of negotiated fee 50% of negotiated fee plus all excess charges
Professional Services
(X-ray, lab, anesthesia, surgeon, etc.)
30% of negotiated fee 50% of negotiated fee plus excess charges
Hospital Inpatient
(Overnight Hospital Stays)
30% of negotiated fee All Charges except $650 per day
Hospital Inpatient
(If You Don't Stay Overnight)
30% of negotiated fee All Charges except $380 per day
Emergency Room Services 30% of negotiated fee 50% of customary and reasonable fees plus all excess charges
Maternity Not Covered Not Covered
Preventive Care

Annual physical exam(s): 30% of negotiated fee

Routine mammogram, Pap and PSA tests: 30% of negotiated fee (deductible waived)

Well Baby and Well Child (through age 6): 30% of negotiated fee

Annual physical exam(s): 50% of negotiated fee plus all excess charges

Routine mammogram, Pap and PSA tests: 50% of negotiated fee plus all excess charges

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

Ambulance 20% of negotiated fee 50% of negotiated fee plus all charges in excess of negotiated fee and in excess of the plan's $75 maximum payment per ground trip
Physical & Occupational Therapy; Chiropractic Services 30% of negotiated fee. Plan pays up to $2,500 per year for therapy and up to $500 per year for chiropactic services 50% of negotiated fee plus all excess charges. Plan pays up to $2,500 per year for therapy and up to $500 per year for chiropactic services
spacer spacer spacer
Prescription Drug
Coverage Options
In-Network
(Receive negotiated savings)
Out-of-Network
(Pay higher costs)
SmartSense with Generic Prescription Drug Coverage
(Drugs on Generic Rx Formulary only)
Generic: $15 copay (or 40%, whichever is greater) Generic: $15 copay (or 40%, whichever is greater)
SmartSense with Comprehensive Prescription Drug Coverage
(Blue Cross Formulary Drugs)

Generic: $15 Copay (or 40%, whichever is greater)

$500 annual brand-name/specialty drug deductible (2 member maximum) applies before the following:

Brand-name: $15 copay (or 40%, whichever is greater); 40% of negotiated fee for self-administered injectables, except insulin.

Specialty: 40% - $4,500 annual out-of-pocket maximum (the most you will have to pay) (In-network only and in addition to brand-name/specialty drug deductible)

Generic: $15 Copay (or 40%, whichever is greater)

$500 annual brand-name/specialty drug deductible applies before the following:

Brand-name: $15 copay (or 40%, whichever is greater); 40% of negotiated fee for self-administered injectables, except insulin.

Specialty: Not covered

Consider Other Blue Cross of California PPO Plan Links
P O Box 6374 Jackson Hole, WY 83002-6374
Home Page || Blue Cross of California || Blue Shield of California || Blue Cross Blue Shield of AZ || Anthem Blue Cross Blue Shield
International Medical Plans || Short Term Plans || SOUND || Tonik Health Plans || UniCare || Enrollment Packet, || For Agents Only
Copyright© 2003-2007 by Teton Marketing Technologies LLC, Timothy N Jennings, All Rights Reserved
 
Touch Automated Lead Manager