PPO Plan

PPO Plan  

Overview

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).

 

How the PPO Plan works

  • 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.

 

Use your PPO Plan wisely

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.
Contact Us

 Website
Anthem
Phone
1.855.492.3558



Forms

These form(s) are in Adobe Acrobat Reader (PDF) format and are available for downloading and printing.

 

2020 Masonite PPO Base Plan Certificate
2021 Masonite PPO Summary of Benefits and Coverage