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| Anthem insurance menu |
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For help or questions
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call 1-866- 508-0618 |
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| Up Front deductible plans-80/20 plans |
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| •80/20 up front plan: These plans have a $250 deductible and then the plan pays 80% and you pay 20%. Once you have paid a total of $1250 plus the $250 deductible, the health plan then pays 100% of the medical care. This plan can include coverage for prescriptions. Your choice. See both plans below. |
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| 80/20 plan, with $2000 prescription benefit |
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| In network benefits |
You pay |
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Purchase This plan |
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| Prescriptions $2000 |
10/25/40 Copay |
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| All Other Medical Care-hospital, surgery, doctors, Preventative care, xrays, diagnostic tests, etc. |
$250 deductible per year, then you pay 20% up to $1250. Then plan pays 100% of medical care. |
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2008 Monthly Costs |
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| In network benefits |
You Pay |
Age |
Male |
Female |
2 Person |
Family |
Age |
| Doctor Copay |
Free |
0-29 |
173.03 |
245.34 |
447.84 |
762.73 |
0-29 |
| Specialist Copay |
Free |
30-34 |
230.60 |
282.33 |
455.38 |
863.48 |
30-34 |
| In Hospital Costs
per person |
Free |
35-39 |
230.60 |
282.33 |
455.38 |
863.48 |
35-39 |
40-44 |
297.75 |
311.13 |
505.76 |
924.81 |
40-44 |
| Out Patient Surgery |
Free |
45-49 |
344.70 |
349.13 |
568.81 |
967.30 |
45-49 |
| Diagnostic Tests |
Free |
50-54 |
469.08 |
482.45 |
823.05 |
1144.44 |
50-54 |
| Simple Xrays |
Free |
55-59 |
613.35 |
609.23 |
1074.90 |
1385.67 |
55-59 |
| Prescriptions $2000 |
10/20/35
| 60-64 |
824.08 |
727.44 |
1363.74 |
1633.75 |
60-64 |
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| This is a short example of coverages and rates. There is 1 other prescription options which allows you to remove prescription coverage and reduce rates further. See plan below for same plan but no benefits for prescriptions. |
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| Get more information on coverages for 80/20 Upfront plans here |
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| 80/20 plan with No Prescription Coverage |
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| In network benefits |
You pay |
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Apply for this plan |
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| Prescriptions $2000 |
Coverage removed |
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| All Other Medical Care-hospital, surgery, doctors, Preventative Care |
$250 yearly deductible then see below |
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2008 Monthly Costs |
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| Coverage |
You Pay |
Age |
Male |
Female |
2 Person |
Family |
Age |
| Doctor copay |
Free |
0-29 |
147.76 |
209.51 |
382.44 |
651.34 |
0-29 |
| Specialist copay |
Free |
30-34 |
196.92 |
241.10 |
388.88 |
737.38 |
30-34 |
| In hospital costs
per person |
Free |
35-39 |
196.92 |
241.10 |
388.88 |
737.38 |
35-39 |
40-44 |
254.27 |
265.69 |
431.90 |
789.75 |
40-44 |
| Out patient surgery |
Free |
45-49 |
294.36 |
298.17 |
485.74 |
826.04 |
45-49 |
| Diagnostic tests |
Free |
50-54 |
400.58 |
411.99 |
702.85 |
977.31 |
50-54 |
| Simple xrays |
Free |
55-59 |
523.78 |
520.26 |
917.92 |
1183.31 |
55-59 |
| Prescriptions |
benefit removed |
60-64 |
703.73 |
621.21 |
1164.58 |
1395.16 |
60-64 |
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| This is a short example of benefits and rates. |
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Go to Anthem Blue Cross Menu |
| Get more information on benefits for 80/20 Upfront plans here |
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| Z 4-18-2008 |
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Creative Health Insurance LLC |
| copyright 2007 |
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