Anthem Consumer Choice Plan

The Anthem Consumer Choice Plan puts you in charge of your health care expenses. Known as a ‘high deductible plan,’ the plan offers low employee premiums, 100% preventive care coverage and a before-tax savings plan, or a Health Savings Account (HSA), to help you pay for your out-of-pocket medical expenses. Here’s how it works:

• Preventive care, including wellness check-ups, immunizations, well-baby care and well-woman care, is covered at 100% when you use an in-network provider. In addition, you pay only a small copay (nothing for generics!) for preventive care prescription drugs, including birth control pills
• For other services, such as a doctor’s office visit when you’re sick, you pay the total amount until you reach the deductible. Your deductible varies based on the level of coverage you have – the in-network deductibles are $1,650 for individual coverage or $3,300 if you cover more than yourself
• Once you meet your deductible, the plan pays a percentage of your total costs, just like a regular PPO plan. The plan pays a higher percentage when you use in-network providers and less when you use out-of-network providers
• You are eligible to open a HSA, and can contribute before-tax dollars to save even more on your medical expenses.

If you reach the annual out-of-pocket maximum in a calendar year – $4,000 per person or $8,000 per family in-network – the plan pays benefits at 100%. The annual out-of-pocket maximum for the Anthem Consumer Choice Plan includes the deductible.  For example, if you elect employee only coverage and meet your in-network deductible of $1,650 in any year, you'll not pay more than $2,350 in coinsurance for in-network care for the remainder of the calendar year ($4,000 maximum).

Out-of-network deductibles are $3,300 for employee only and $6,600 for employee plus one or more, with an annual out-of-pocket maximum of $8,000 per employee and $16,000 for employee plus one or more.