The PPO Plan offers lower out-of-pocket costs in exchange for higher premiums. With this plan, your costs are more predictable, but you’ll likely still have out-of-pocket expenses. Instead of an HSA, this plan allows you to contribute pre-tax money to a Health Care Flexible Spending Account (FSA).
- You receive in-network preventive care at no cost. This includes annual physicals, immunizations, and recommended screenings.
- For nonpreventive doctor’s visits and generic prescriptions, you pay a flat copay without needing to meet the deductible.
- For most other health care services, you pay 100% of the negotiated costs until you meet the annual deductible.
- Once you satisfy the deductible, you’ll pay a percentage of your covered medical expenses; this amount is called your coinsurance.
- If your deductible and coinsurance expenses reach the out-of-pocket maximum, then the plan pays 100% of your eligible expenses for the rest of the year.
Here are ways to make the most of your plan all year long.
- Track your stats. Log in to the Anthem website to see how much of your deductible you’ve met, review claims, and more.
- Pair it with a Health Care FSA. If you enroll in the Health Care FSA, you can set aside pre-tax dollars to help pay for your out-of-pocket costs. Keep in mind, the money in your FSA does not carry over to the next plan year; you must “use it or lose it.”
- Be cost-conscious. Visit the Anthem website to search for in-network providers and use the tools to compare costs for medical services.