Anthem Blue Cross is the largest health insurer in the Blue Cross Blue Shield Association of America. In California, the insurer operates as Anthem Blue Cross and has approximately 800,000 customers, making it one of the largest health insurers. Operates as Empire Blue Cross Blue Shield in New York State and Anthem Blue Cross and Blue Shield in 10 states.

Whether you’re new to Anthem Blue Cross or have been a member for years, you can trust that Anthem Blue Cross will continue to prioritize your health coverage needs. Additionally, Anthem Blue Cross strives to make the most of your health coverage by supporting you every step of the way. From choosing the right individual plan to connecting you with the right doctors, Anthem Blue Cross is committed to simplifying and caring for every aspect of your health. With comprehensive coverage that includes medical, dental, vision, pharmacy, and behavioral health needs, you can rest assured that you’re getting the support and coverage you need to stay healthy and thrive.

When choosing a healthcare plan, it’s crucial to consider the network that comes with it. In fact, each plan has a specific network, which may vary in size and offer different options for local providers. Therefore, it’s essential to understand the differences between the networks and assess your healthcare needs carefully. By doing so, you will be able to make an informed decision that meets your specific requirements.

2024 Anthem Blue Cross HMO Plans

When it comes to healthcare, an HMO (health maintenance organization) can be a cost-effective option. However, to receive care within an HMO network, you must choose a primary care physician who will manage your healthcare needs and refer you to other in-network doctors as necessary. It’s important to note that HMOs typically do not cover services received outside of their network, except for emergency and urgent care or with prior approval. If you choose to receive care from an out-of-network provider, you may need to pay out of pocket unless state or federal laws apply.

HMO plans are currently available in several counties across California, including Fresno, Kings, Los Angeles, Madera, Orange, Riverside, San Bernardino, and San Diego.

Below are additional details regarding the benefits of in-network services within an HMO plan.

2024 Anthem Blue Cross EPO Plans

Anthem Blue Cross EPO Plan offers members access to a network of hospitals and healthcare providers partnered with Anthem to provide services at pre-negotiated, discounted rates. The plan has a maximum allowed amount that determines the benefits for in-network providers. Providers who have an agreement with Anthem are considered in-network and have agreed to accept the maximum allowed amount as payment in full.

However, if you choose to use an out-of-network provider who does not have an agreement with Anthem, your personal financial costs may be considerably higher than when using in-network hospitals or providers. It’s important to note that EPO plans do not offer out-of-network benefits, which means that members will be responsible for all costs, with some exceptions such as emergency services. EPO plans are available in many counties across California, including Alameda, Contra Costa, San Francisco, Santa Clara, Ventura, and many more.

Below are some additional details regarding the benefits of the EPO plan.

EGIBILITY AND KEY ENROLLMENT DATES

 Eligibility for Minimum Coverage Plan

  • Under 30 years of age before the plan’s effective date
  • Received certification from Covered California that qualifies for a hardship exemption or does not have an affordable coverage option.

Open Enrollment Period

  • An annual open enrollment period is provided for enrollees in compliance with state and federal requirements.
  • Actual effective date is determined by the date Anthem receives a complete application with the applicable premium payment.
  • Payment received between November 1st – December 31st, member will have a January 1 effective date.
  • Payment received January 1 – January 31, member will have a February 1 effective date.

Special Enrollment Period

  • Individuals can enroll during the special enrollment period in addition to open enrollment.
  • Eligible individuals or their dependents can enroll after the open enrollment, typically due to an event such as marriage, birth, adoption, or other qualifying events as defined by law.

 

2024 Anthem Blue Cross Plans

 Gold and Platinum Plans: If you require frequent medical care, the Anthem Blue Cross Platinum and Gold Plans offer various options and are highly recommended. These plans come with high monthly premiums but low copays and no deductibles.

 Silver Plans: For individuals who require medical attention occasionally and are seeking a balanced approach between monthly plan premiums and the cost of care, the Anthem Blue Cross Silver Plans emerge as an excellent choice. Not only do these plans offer moderate premiums, but they also feature reasonable deductibles and copayments.

Bronze Plans: If you are someone who rarely visits the doctor but wants protection in an emergency, the Anthem Blue Cross Bronze Plans could be a great option for you. Typically, these plans offer lower monthly premiums, but it’s important to note that you may incur higher out-of-pocket costs when you receive care.

2023 Anthem Service Area

 

Need help with Anthem Blue Cross Health Insurance in 2024? 

Skyline Benefit is an independent health insurance broker in Fullerton, CA, that offers affordable and flexible health insurance options.  Selecting the best health insurance plans can be overwhelming; our mission is to simplify the process and help our clients every step of the way.

Schedule a consultation today. Call us at: (714) 888-5112

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