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| Lumenos
HSA Plan at a Glance: |
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Features
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Anthem
Lumenos HSA
| | Lifetime
Maximum Benefit | - $3
million per member | | Doctor
Office Visits | - 100%,
80%, or 70% in network after deductible
- 70%, 60%, or 50% out of network after deductible |
| Wellness
Benefit
* | - 100%
All approved preventive care covered ** | Prescription
Drugs
| - 100%,
80%, or 70% in network after deductible
- 70%, 60%, or 50% out of network after deductible |
| Hospital
Services | - 100%,
80%, or 70% in network after deductible
- 70%, 60%, or 50% out of network after deductible |
Plan
Deductible
This is the amount you pay each calendar
year before benefits are paid. |
- Please run an instant
quote for deductibles in your area | | Chiropractic
Care | - 100%,
80%, or 70% in network after deductible
- 70%, 60%, or 50% out of network after deductible |
Network
Coinsurance
This is the percentage of covered medical
expenses Anthem pays after the deductible is met. | - 100%,
80%, or 70% in network after deductible | Non-network
Coinsurance
If you go out of network, this is the limit of
covered medical expenses you pay after the deductible is met. | - 70%,
60%, or 50% after deductible | All
Other Services
| - All
Covered Services, including prescription drugs, are subject to deductible
and coinsurance. | |
| * | Children
services are not subject to deductible for age appropriate visits and routine
immunizations, and are subject to the coinsurance limits of your plan. Age
specific mammogram screening and prostate screening are covered and are not subject
to deductible or coinsurance. Maximum payment of $500 per year. |
| ** | When
you use providers in the network, nationally recommended preventive care services
are paid for by Anthem, at zero cost to you. |
This information
is presented only as a very brief overview of some of the benefits of this plan,
and is intended only for general education. The amount of benefits provided
depends on the plan selected. Premium will vary with the type of benefits selected.
These plans contain exclusions from and limitations of coverage. Please
see the product brochure for more complete information, as well as information
about terms of renew ability, preexisting conditions, out-of-network penalties,
and notification requirements. Plans are subject to health underwriting.
To be considered for reimbursement, expenses must qualify as covered expenses.
Expenses are also subject to reasonable and customary limits, unless you use
a network, and all other policy provisions, including determinations of medical
necessity.
Coverage
Synopsis:
The Anthem
Lumenos HSA plan is available in a 100%, 80/20 or 70/30 version. 100%
Plan: this option pays 100% of all covered expenses up to the lifetime maximum
after your deductible has been met. 80/20
Plan: this option pays 80% of all covered expenses up to $10,000 for individuals
and $20,000 for families, after the deductible has been met, then 100% up to
the lifetime maximum. Your out of pocket maximum is $5,000 for individuals
in network and $10,000 for families in network. 70/30
Plan: this option pays 70% of all covered expenses up to $10,000 for individuals
and $20,000 for families, after the deductible has been met, then 100% up to
the lifetime maximum. Your out of pocket maximum is $5,000 for individuals
and $10,000 for families. The
deductible for each of these plans needs to be met only once for the entire
family. Please run an instant quote
for deductibles in your area. All
nationally recommended preventive care services are 100% covered. You
choose your own doctor and you never need referrals-but when you use Anthem's
network providers, you can save money by receiving Anthem's negotiated discounts
on services and prescriptions. You'll
have access to these exclusive Health Tools and Personalized Services:
- An online Health Assessment
designed to help you measure your overall health.
-
A Personal Health Coach Program, Smoking Cessation Program, and Weight Management
Program.
- 24-Hour
Nurse Advice Line when you need a quick answer to a routine health question
or advice on a medical issue.
-
An online health site with tools and information, including network provider
listings, hospital quality ratings, prescription drug costs, wellness articles,
and much more.
Plan
Options :
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Choose
the Best Individual Plan for You
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Deductible
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Coinsurance
amount plan pays in-network/out-of-network after deductible is
met
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Annual
Out-of-pocket Maximum
| |
$1,500
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100%
/ 70%
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$1,500
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$1,500
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70%
/ 50%
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$5,000
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$2,500
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100%
/ 70%
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$2,500
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$2,500
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80%
/ 60%
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$5,000
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$3,000
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100%
/ 70%
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$3,000
| |
$3,000
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80%
/ 60%
|
$5,000
| |
$5,000
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100%
/ 70%
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$5,000
| | | |
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Choose
the Best Family Plan for You
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|
Deductible
|
Coinsurance
amount plan pays in-network/out-of-network after deductible is
met
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Annual
Out-of-pocket Maximum
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$3,000
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100%
/ 70%
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$3,000
| |
$3,000
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70%
/ 50%
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$10,000
| |
$5,000
|
100%
/ 70%
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$5,000
| |
$5,000
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80%
/ 60%
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$10,000
| |
$6,000
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100%
/ 70%
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$6,000
| |
$6,000
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80%
/ 60%
|
$10,000
| |
$10,000
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100%
/ 70%
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$10,000
| | | |
Note:
Please run an instant quote for exact
deductibles in your area.
Rate
Information:
Please run
an instant quote to see available rates.
The HSA-qualified
Lumenos Consumer-Driven Health Plans for Individuals have standard rates and
rates for tobacco users. You may be eligible for a standard rate if you
haven’t used any tobacco products (cigarettes, cigars, chewing tobacco
or pipe) during the 12 consecutive months before your application date.
If you’re applying for family coverage, Anthem will individually rate each
person listed on the application based on the person’s tobacco use.
Your monthly rate is also partially determined by the ZIP code for your home
address. We have two ZIP code rating areas in Nevada, one for the Las
Vegas area and another for the rest of the state. All
individual Lumenos plans have a one year rate guarantee, based on the anniversary
date of the policy. Anniversary month will be assigned for the first of
the month if effective date is the first, or the following first of the month
for requested effective dates after the first.
PPO
Network:
Anthem gives
you access to one of the largest networks in Nevada, with nearly 8,500 health
care providers and over 60 hospitals throughout the state. The large list
of doctors and hospitals can be viewed at the Anthem
PPO Online Provider Directory.
Make sure to choose the "BluePreferred PPO" plan. Policyholders
can go to Blue Cross doctors anywhere in the country, and can even access a
world-wide network.
Underwriting:
Anthem has
one of the easiest, most efficient underwriting teams in the industry. The
process is very fast if no medical records are needed. While it is always
a good idea to apply at least three weeks prior to the time you need your new
coverage to take effect, most applications that are done online are approved
by Anthem within 24 hours. If medical records must be ordered, the application
process will take longer. The
company does have the right to accept or decline any individual or family application.
Certain conditions may be waivered with a temporary rider (usually for one to
two years), or an indefinite rider. If you are currently being treated
for depression, anxiety, or high cholesterol, please let us know before you
apply so we can avoid unnecessary delays in getting you covered. For
an infant less than 6 months of age, Anthem requires nursery records from the
hospital where the infant was born, office records from the infant’s pediatrician,
and results of the newborn screening laboratory tests (available from the hospital
or pediatrician). Anyone
applying for Anthem coverage that has any of the following pre-existing conditions
also needs to complete the appropriate form and return it to our office via
fax toll
free at 1-866-284-0082
as promptly as possible.
Effective
dates:
The coverage
can go into effect in as quickly as 24 hours, though the applicant risks being
declined if claims are submitted before the underwriting process is completed.
You may request an effective date any time after the date you sign the application
and 60 days later. Please note that you will be billed starting on
your requested effective date, even if you have not yet been notified that you
have been approved. This is very good for someone who does not have any
present coverage and would like for their benefits to begin right away. For
those who are already covered, it is suggested that you maintain your current
coverage in force until you have received notice from either HSA
for America
or directly from Anthem that your policy has been approved and is in
force. Your
earliest possible effective date will be the day after Anthem has received all
the necessary documents and information needed to process your application.
HSA
Administrator
You may set
up your health savings account with any qualified HSA trustee or administrator,
regardless from which insurance company your purchase your HSA-qualified health
insurance. Anthem Blue Cross and Blue Shield have chosen Mellon Trust
to be their administrator. If you would like to set up your health savings
account with Mellon Trust, you may submit your HSA application together with
your health plan application. The Anthem-sponsored Mellon Trust has the
following fees: -
One Time Account set-up fee: $15.00
- HSA
administration fee: $2.95 per month
- Debit
Card Transactions: no charge
- Check writing:
no charge
- ATM Transactions:
$1.00
- Card Replacement
fee: $5.00
- Check Reorder:
$10.00
- Non-sufficient
funds: $25.00
- Stop check
Service: $25.00
- Duplicate
check fee: $5.00
You may also
choose one from our HSA administrator page, where you
can compare rates and features.
About
Anthem:
The company
known today as Anthem is the outgrowth of two Indianapolis-based corporations
formed in 1944 and 1946 as mutual insurance companies. Those two companies
were created to provide health insurance to residents of Indiana as Blue Cross
of Indiana. In the mid-1980s, Blue Cross and Blue Shield of Indiana began
to diversify and expand, primarily through Blue Cross and Blue Shield mergers
and acquisitions. The Anthem Blue Cross and Blue Shield companies are
independent licensees of the Blue Cross and Blue Shield Association and currently
serve more than 12.6 million customers in nine different states. Anthem
is listed on the New York Stock Exchange under the trading symbol ATH, and is
the fifth largest publicly traded health benefits company in the United States.
Anthem
Blue Cross Blue Shield of Nevada has been assigned a rating of "A"
(Excellent) from the A.M.
Best Company, an independent insurance rating organization. HSA
for America is an independent authorized Anthem agent.
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