Page 5 - Premier EE Guide 12-17 - Texas final

MEDICAL INSURANCE

MEDICAL INSURANCE

Option 1
Anthem Blue Cross | PPO Medical Plan
The Anthem Blue Cross Preferred Provider Organization (PPO) plan allows you to direct your own care. You are not limited to the
physicians within the network and you may self-refer to specialists. If you receive care from a physician who is a member of the
PPO network, a greater percentage of the entire cost will be paid by the insurance plan. You may also obtain services using a non‐
network provider; however, you will be responsible for the difference between the covered amount and the actual charges and
you may be responsible for filing claims.

Option 2
Anthem Blue Cross | HSA Medical Plan

With the HSA plan through Anthem Blue Cross, you can pay for qualified healthcare expenses now and grow your savings for future
healthcare needs. This plan combines a High Deductible Health Plan (HDHP) with a special, tax-qualified savings account (HSA). You
can contribute tax-free money to your HSA up to IRS maximums. The money in your account is yours to pay for current healthcare
expenses - or you can save toward future healthcare expenses. Similar to the PPO plan, you have the freedom to choose your
doctor without the requirement of selecting a PCP and you may self-refer to specialists. You may use a network provider whose
negotiated rates provide richer levels of benefits with claim forms filed by the providers. You may also obtain services using a non-
network provider; however, you will be responsible for the difference between the covered amount and the actual charges and
you may be responsible for filing claims. Additional information about how the HSA plan works is located on page 6 of this guide.

Finding a Medical Provider
• Option 1 or 2: Go to www.anthem.com/ca or call (855) 333-5730. Refer to the “Prudent Buyer PPO” network.

LiveHealth Online

LiveHealth Online uses two-way video to connect you with U.S. board certified doctors over the internet. You can see a doctor on
the go, right from your mobile device. Doctors can answer your questions, make a diagnosis and even prescribe basic medications,
if you need them. Enrolling is 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 first language, try searching for a doctor based on your language preference. You can use LiveHealth Online for
many different health issues, such as colds, the flu, allergies, sinus infections, bronchitis, diarrhea, and family health. Keep in mind,
LiveHealth Online is not for emergencies. If you experience an emergency, you should go to the emergency room or call 911. Go to
www.livehealthonline.com. Select “Sign Up” if you do not have an account. Click “Log In” if you do have an account. Complete the
information about yourself and your health issue, then search for a doctor in your area.

24/7 Nurseline

You may call the 24/7 NurseLine to speak with a registered nurse about your health concern. Whether it’s a question about
allergies, fever, types of preventive care, or any other topic, nurses are always there to provide support and peace of mind. And, if
you want, a nurse will call you later to see how you’re doing. Anthem’s nurses can help you choose the right place for care if your
doctor isn’t available and you aren’t sure what to do. If you’d prefer not to talk about your health concern over the phone, the
AudioHealth Library might be for you. These helpful prerecorded messages cover more than 300 health topics in English and
Spanish. Just call the 24/7 NurseLine number and choose the AudioHealth Library option. The 24/7 NurseLine is always here for
you. Anthem’s Member Services Department can connect you when you them call toll free at (800) 700-9186.

Case Management
Case Management programs provide you with personalized care. Services include:
• Future Moms: This program helps you take care of your baby before you deliver. Each future mom (and dad) gets 24-hour
access to a nurse coach, newborn care, and much more.
• ConditionCare: This program helps you and your covered dependents manage and live with chronic conditions like asthma,
diabetes, COPD, and heart disease.
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