City of LA employees,
See the doctors you know and love With Anthem Blue Cross health plans, you’ll get access to more doctors in California. 1 anthem.com/ca/cityofla
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Get the best care for you and your loved ones with Anthem Blue Cross At Anthem, our focus is on your well-being and the health of the Los Angeles community that we’re so proud to be a part of. So we’re happy to offer you four health plans that give you the freedom to choose the best doctors and hospitals. And because these doctors and hospitals are part of our plans, you and your family will pay less when you use them. We also know that your health needs are just as unique as you, so our plans come with convenient services and tools that can help you live a healthy life. At Anthem, we put the focus on you and your well-being.
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Connecting you to care and convenience No matter which plan you choose, you’ll enjoy these tools and services that can help you get your health questions answered, find doctors and access care.
LiveHealth Online When you can’t get to the doctor’s office, you can have a video visit with a doctor 24/7 using your smartphone, tablet or computer with a webcam. Doctors on LiveHealth Online can talk to you about your health, give you a diagnosis and even a prescription, if you need it.1 People most often use LiveHealth Online for a cold, the flu, allergies, pink eye and more. There’s also LiveHealth Online Psychology, where you can schedule an appointment to see a licensed therapist in 3-4 days. Plus, doctors on LiveHealth Online can talk to you in Spanish. You’ll have a small copay when you visit a LiveHealth Online doctor. It’s that simple.
Mobile Health Consumer app Access tools to keep you connected to important health information 24/7. You can get your mobile ID card, connect with your care team, find urgent care – with directions, and much, much more. You can use Mobile Health Consumer app from your computer or your mobile device. Go to mobilehealthconsumer.com to register and access it from your computer.
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Go to the App Store® or Google PlayTM to download the app to your mobile device.
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Onsite member advocate Starting on October 3, you’ll have access to a member advocate right in the heart of City Hall at the Personnel Office. The member advocate is an Anthem employee who will be ready to help you find doctors, get a referral and answer questions about your claims. They will also be able to help you with benefit concerns and answer questions to help you get the most of your Anthem benefits and programs.
BlueCard Worldwide® Getting health care in some parts of the world can be tricky. As an Anthem member you get coverage outside of the U.S. through the BlueCard Worldwide Program. That’s right; you’ll be able to find doctors and hospitals in nearly 200 countries and territories around the world.2
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Meet the plans Vivity – a better health care experience What’s different about Vivity: You get all of the tools that come with an Anthem plan plus: Access to top-ranked doctors, hospitals and health systems in L.A. and Orange County
More ways to get special care
•• Cedars-Sinai
• Wider range of choices from top-ranked specialists across the Vivity network
•• Good Samaritan Hospital •• Huntington Hospital •• MemorialCare Health System •• PIH Health •• Torrance Memorial Medical Center •• UCLA Health
While your Vivity-participating provider will refer you to a Vivity network hospital, you are still covered in Anthem’s 400+ network California hospitals. 4
• Visit certain kinds of specialists without a referral
• A network of over 8,800 doctors throughout Los Angeles and Orange County • Through physician directed access – which is unique to Vivity, a member can be referred by their PCP in their assigned medical group to a specialist in another Vivity medical group
Anthem Blue Cross Full Network HMO (CACare) Plan With this plan you’ll enjoy a system of doctors statewide.
How big is the network? 43,000+ doctors and specialists, 400+ hospitals across California.
Anthem Blue Cross Narrow Network (Select HMO) Plan This plan works under our high-performance system of doctors and providers committed to keeping costs affordable. Plus, you’ll have access to doctors in 22 different counties.
How big is the network? 26,500+ doctors and specialists, 400+ hospitals across California.
Anthem Blue Cross PPO plan This plan gives you the choice to see any doctor or hospital you want, but you’ll receive greater benefits and pay less when you use doctors and hospitals in the Anthem Blue Cross PPO plan. That’s because these doctors and hospitals have signed contracts with us to accept our rates, which keeps your overall costs lower.
How big is the network? 62,000+ doctors and specialists, 400+ hospitals across California.
What’s a HMO plan? A health maintenance organization (HMO) plan requires you to get health care only from doctors that are part of your plan. Usually a primary care doctor coordinates your care. If you choose to go to doctors outside of your plan, services aren’t covered by your plan and you’ll have to pay out of pocket.
What’s a PPO plan? A preferred provider organization (PPO) plan lets you see doctors in your plan and outside of your plan. However, you’ll usually pay more for care when you get care from doctors outside of your plan. 5
It’s totally up you! Compare basic information about our four plans using this handy chart. You can check out some of the most common services and decide what’s most important to you and your family depending on how often you may need these services. Anthem Blue Cross Vivity HMO plan (LA and Orange counties)
Anthem Blue Cross Full Network (CACare) HMO plan
Anthem Narrow Network (Select) HMO plan
All HMO Plans
In plan
In plan
In plan
Out of plan
In plan
Out of plan
$0
$0
$0
$0
$750 single / $1,500 family
$1,250 single / $2,500 family
500 single / $1,500 family
500 single / $1,500 family
500 single / $1,500 family
$0
2,000 single / $4,000 family
$2,000 single / $4,000 family
Primary care doctor visit
$15 copay
$15 copay
$15 copay
Not covered
$30 copay
30% your percentage of the costs
Specialist office visit
$15 copay
$15 copay
$15 copay
Not covered
$30 copay
30% your percentage of the costs
LiveHealth Online visit — 24/7
$15 copay
$15 copay
$15 copay
N/A
$30 copay
N/A
Chiropractor
$15 copay
$15 copay
$15 copay
Not covered
10% your percentage of the costs
30% your percentage of the costs
Acupuncture
$15 copay
$15 copay
$15 copay
Not covered
10% your percentage of the costs
30% your percentage of the costs
Lab services
No charge
No charge
No charge
Not covered
30% your percentage of the costs
Emergency
$100 copay
$100 copay
$100 copay
Covered as in plan
10% your percentage of the costs $100 copay per visit and then 10% your percentage of the costs
Urgent care
$15 copay
$15 copay
$15 copay
N/A
$30 copay
30% your percentage of the costs
Inpatient hospital
No charge
No charge
No charge
Not covered
10% your percentage of the costs
30% your percentage of the costs
Deductible Out-of-pocket limit
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Anthem Blue Cross PPO plan
Covered as in plan
This is not a complete listing or description of the benefits available to you. Please refer to your Summary Plan Description for more detail.
Covered Prescription Drug Benefits The following chart outlines your pharmacy benefits.
Anthem Blue Cross Vivity HMO plan (LA and Orange counties)
Anthem Blue Cross Full Network (CACare) HMO plan
Anthem Narrow Network (Select) HMO plan
In plan
In plan
In plan
In plan
Out of plan
Pharmacy Deductible
$0
$0
$0
$0
$0
Pharmacy Out of Pocket
$0
$0
$0
$0
$0
Anthem Blue Cross PPO plan
Preventive Pharmacy Preventive Immunization
$0 copay (retail only)
$0 copay (retail only)
$0 copay (retail only)
$0 copay (retail only)
25% your percentage of the costs (retail only)
Female oral contraceptive Generic and Single Source brand
$0 copay (retail only)
$0 copay (retail only)
$0 copay (retail only)
$0 copay (retail only)
25% your percentage of the costs (retail only)
Prescription Drug Coverage This plan uses a National Drug List. Drugs not on the list are not covered
Tier1 - Typically Generic
$10 copay per prescription (retail only) and $20 copay per prescription (home delivery only)
$10 copay per prescription (retail only) and $20 copay per prescription (home delivery only)
$10 copay per prescription (retail only) and $20 copay per prescription (home delivery only)
$10 copay per prescription (retail only) and $20 copay per prescription (home delivery only)
25% your percentage of the costs (retail only)
Tier2 - Typically Preferred / Brand
$20 copay per prescription (retail only) and $40 copay per prescription (home delivery only)
$20 copay per prescription (retail only) and $40 copay per prescription (home delivery only)
$20 copay per prescription (retail only) and $40 copay per prescription (home delivery only)
$20 copay per prescription (retail only) and $40 copay per prescription (home delivery only)
25% your percentage of the costs (retail only)
Tier3 - Typically Non-Preferred / Specialty Drugs
$40 copay per prescription (retail only) and $80 copay per prescription (home delivery only)
$40 copay per prescription (retail only) and $80 copay per prescription (home delivery only)
$40 copay per prescription (retail only) and $80 copay per prescription (home delivery only)
$40 copay per prescription (retail only) and $80 copay per prescription (home delivery only)
25% your percentage of the costs (retail only)
Tier4 - Typically Specialty Drugs
$40 copay per prescription (retail only) and $80 copay per prescription (home delivery only)
$40 copay per prescription (retail only) and $80 copay per prescription (home delivery only)
$40 copay per prescription (retail only) and $80 copay per prescription (home delivery only)
$40 copay per prescription (retail only) and $80 copay per prescription (home delivery only)
25% your percentage of the costs (retail only)
This is not a complete listing or description of the benefits available to you. Please refer to your Summary Plan Description for more detail.
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Now that you know the basics about each plan, learn more about your new Anthem benefits at anthem.com/ca/cityofla
1 Prescription availability is defined by physician judgment and state regulations. LiveHealth Online is available in most states and is expected to expand in the near future. Visit livehealthonline.com to view the service map by state. 2 Blue Cross and Blue Shield Association, Coverage Home and Away (accessed November 2015): bcbs.com/already-a-member/coverage-home-and-away.html. LiveHealth Online is the trade name of Health Management Corporation, a separate company, providing telehealth services on behalf of Anthem Blue Cross. Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.
