Anthem Blue Cross Blue Shield of Connecticut  
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Anthem Blue Cross HMO Plans - only 2

For help or questions Call 1-866-508-0618
     

 

  How to Apply for Anthem  
Anthem HMO plan #1 - $500 Prescriptions          
    2010 Monthly Rates and Prices  
Coverage You Pay
Age
Male
Female
2 Person
Family
 
Doctor Copay $20
0-29
246.55
444.52
732.93
1,181.56
 
Specialist Copay $30
30-34
328.20 497.23 743,77 1325.25  
In Hospital Costs Hospital & Surgery
35-39
328.20 497.23 743.77 1325.25  
40-44
424.35
538.06
815.63
1,412.61
 
Out Patient Surgery $1500 per year
45-49
491.03
592.33
905.55
1,473.07
 
Diagnostic Tests Free
50-54
668.31
687.44
1,172.77
1,630.73
 
Simple Xrays Free
55-59
868.93
863.62
1,531.49
1,974.43
 
Prescriptions $10/$25/$40 Copays
60-64
1,149.60
1,020.61
1,943.43
2327.99
 
View & Print Anthem rates and medical benefits. $500 Prescription per year  
 
               
    How to Apply for Anthem  
Anthem HMO plan #2 -$2000 Prescriptions          
     
2010 Monthly Rates and Prices
 
Coverage You Pay
Age
Male
Female
2 Person
Family
 
Doctor Copay $20
0-29
262.35
473.00
779.90
1,257.27
 
Specialist Copay $30
30-34
349.23
529.09
791.43
1,410.17
 
In Hospital Costs Hospital & Surgery
35-39
349.23
529.09
791.43
1,410.17
 
40-44
451.54
572.53
867.90
1,503.13
 
Out Patient Surgery $1500 per year
45-49
522.49
630.28
963.57
1,567.46
 
Diagnostic Tests Free
50-54
711.13
731.49
1,247.92
1,735.22
 
Simple Xrays Free
55-59
930.03
923.98
1,629.62
2,100.95
 
Prescriptions $10/$20/$35 Copays
60-64
1,249.58
1,102.72
2,067.96
2,477.16
 
View & Print Anthem rates and medical benefits. $2000 Prescription per year  
 
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Z June 17, 2010  

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