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Medical Insurance: HMO Features

• HMO plans are designed to cost less because your doctor coordinates all your care
(you must choose a primary doctor during enrollment).

• Your insurance only covers the costs when you receive care from the specified network (there is no out-of-network coverage).
• Any specialized care (dermatologists, chiropractor, etc.) must be obtained through a referral from your primarydoctor
(you can’t refer yourself to your own specialists).
• There is no deductible (the minimum amount to pay out-of-pocket before you are covered).

ANTHEM HMO KAISER HMO
Your cost per paycheck $ $

TL;DR
Choose your doctor within the
Kaiser network and they’ll coordinate
Choose your doctor within the any referrals or authorizations you
Anthem HMO network and they’ll might need.
coordinate any in-network authorizations
or referrals you might need. All care (specialists, pharmacy)
is through a Kaiser facility.

Good for Rioters who don’t mind staying in the
Rioters who want to stay in the Anthem Kaiser network and having their care
network and have their care coordinated coordinated through their doctor in a one
completely through their doctor
stop shop facility
Doctors you can see Anthem doctors accepting HMO Kaiser facilities only
(Network) (includes UCLA and Cedars Sinai)
Doctors focused on
specific conditions Get a referral from your doctor first. Get a referral from your doctor first.
(Specialists)

Medications Most pharmacies accepted Kaiser facilities only
Amount you pay before
insurance covers doctor’s bills None None
(Deductible)

Most you pay in a year
for medical services In-Network: $1,500 Solo / $3,000 Family In-Network: $1,500 Solo / $3,000 Family
(Out-of-Pocket Maximum)
Cost at service $20 $20
(Office Visit Copay)
Find doctors in the network
Go to www.anthem.com/ca Go to www.kaiserpermanente.org
Check out the provider finder videos
on RiotNet Network name: Locate your nearest Kaiser facility
Blue Cross HMO as you will only get coverage at Kaiser
(CACare) - Large Group (except in case of an emergency)

For all of our plans, emergency care is covered anywhere in the world. If you find yourself in an ER that isn’t affiliated with your
medical group, contact your plan’s member services as soon as you can. Contact information can be found on page 27.