Page 6 - Galassos EE Guide 10-18_ENG_FINAL
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BENEFITS
MEDICAL INSURANCE
EBA&M LiveHealth Online
Plan Name (Anthem Blue Cross) LiveHealth Online uses two-way video to connect you with
Network PPO Plan U.S. board certified doctors over the internet. You can see
Network Name Prudent Buyer Network a doctor on the go, right from your mobile device. Doctors
(California Only) can answer your questions, make a diagnosis and even
prescribe basic medications, if you need them. Enrolling is
Health Benefits really quick and easy. Then, each time you log in, you’ll see
doctors that are available in your state. If English isn’t your
Lifetime Maximum Benefit Unlimited
first language, try searching for a doctor based on your
Deductible (Annual) language preference. You can use LiveHealth Online for
- Individual $250 many different health issues, such as colds, the flu,
- Family $500 allergies, sinus infections, bronchitis, diarrhea, family
Co-Insurance (Plan Pays) 85% health. Keep in mind, LiveHealth Online is not for
emergencies. If you experience an emergency, you should
Office Visit Copay go to the emergency room or call 911.
- Primary Care Physician $20 Copay
- Specialist Office Visit $40 Copay
- Urgent Care $20 Copay
- LiveHealth Online $10 Copay Accessing LiveHealth
Online
Out-of-Pocket Maximum Website: Go to
- Individual $5,000 www.livehealthonline.com. Select
- Family $10,000
“Sign Up” if you do not have an
Hospitalization account. Click “Log In” if you do have
- Inpatient Deductible, 15% an account. Complete the
- Outpatient Deductible, 15% information about yourself and your
health issue, then search for a doctor
Lab and X-Ray
in your area.
- Diagnostic $10 Copay
Mobile App: Download and open the
- Advanced Imaging Deductible, 15%
LiveHealth Online app for Apple and
Emergency Services $150 Copay, 15% Android devices. Create a six-digit
pin number. You’ll need this number
Preventive Care No Charge
every time you use the app.
Physical Medicine / $20 Copay Complete the “Tell Us About
Occupational Therapy / Max 60 Visits/Year Yourself” page to begin.
Chiropractic
Pharmacy Benefits
Retail Pharmacy
- Generic Formulary $10 Copay
- Brand Name Formulary $35 Copay
- Non-Formulary 50% Max $150 Copay
- Supply Limit 30 Days
Mail Order Pharmacy
- Generic Formulary $20 Copay
- Brand Name Formulary $70 Copay
- Non-Formulary 50% Max $300 Copay
- Supply Limit 90 Days
Specialty Drugs 50% Max $500 Copay
- Out-of-Pocket Maximum $7,900 Ind / $15,800 Family
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