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3500
PPO HSA
plan information page
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HSA-qualified
plans are the most popular coverage offered by Anthem
Blue Cross in California. These plans
offer substantially lower premiums, along with the opportunity
to put tax-deductible money in a special account which
can be used to pay your deductible and other medical expenses.
With
the Lumenos HSA plan you get exclusive health tools and personalized
services designed to improve and maintain your health and enhanced control
over your health care dollars.
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| Lumenos
HSA Plan at a Glance: |
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Features
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Lumenos
HSA
| | Lifetime
Maximum Benefit | - $5
million | | Doctor
Office Visits | - 100%,
80%, or 70% after deductible | | Wellness
Benefit
* | - 100%
All approved preventive
care 
covered ** |
Prescription
Drugs
|
- 100%,
80%, or 70% after deductible |
| Hospital
Services |
- 100%,
80%, or 70% 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
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| Chiropractic
Care |
- 100%,
80%, or 70% after deductible |
Network
Coinsurance
This is the percentage of covered medical
expenses BCCA pays after the deductible
is met. |
- 100%,
80%, or 70% 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
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- All
Covered Services, including prescription drugs, are
subject to deductible and coinsurance. |
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| * |
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. |
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When
you use providers in the network, nationally recommended preventive
care services are paid for by BCCA, 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.
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Coverage
Synopsis:
The
Anthem Blue Cross 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 $25,000 for individuals and $50,000 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.
70/30
Plan: this option pays 70% of all covered expenses up
to $16,667 for individuals and $33,333 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, as listed on the Lumenos
Preventive Services list.
You
choose your own doctor and you never need referrals, but
when you use BCCA's network providers, you can save money
by receiving BCCA'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.
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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.
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An online health site with tools and information, including
network provider listings, hospital quality ratings, prescription
drug costs, wellness articles, and much more.
Combining
a Health
Savings Account (HSA) with any BCCA HSA plan allows
you to make tax-deductible contributions, pay medical expenses
with pre-tax dollars, and earn tax-deferred interest.
This account works much like an IRA, except you may use
your tax-free savings for qualified medical expenses your
health plan does not cover, such as your deductible, contact
lenses, or most types of alternative medicine (see the qualified
medical expenses). If you do not use these
funds, they simply accumulate with interest, for distribution
upon your retirement.
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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
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$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
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$3,000
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80%
/ 60%
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$5,000
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$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
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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
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$3,000
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100%
/ 70%
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$3,000
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$3,000
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70%
/ 50%
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$10,000
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$5,000
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100%
/ 70%
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$5,000
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$5,000
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80%
/ 60%
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$10,000
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$6,000
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100%
/ 70%
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$6,000
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$6,000
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80%
/ 60%
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$10,000
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$10,000
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100%
/ 70%
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$10,000
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Rate
Information:
Rates
vary based upon zip code, age, and effective date. You
can get an instant
quote online.
The
premium can be paid monthly, quarterly, semi-annual, or
annual billing, or a monthly bank draft. The initial
premium can be paid with a check, credit card, or bank draft.
PPO
Network:
Anthem
Blue Cross gives you access to one of the largest networks
in California, with thousands of health care providers throughout
the state. Having access to the PPO network can mean
substantial discounts in what you pay for your health care,
even before you meet your deductible. The large
list of doctors and hospitals can be viewed at their online
directory.
Underwriting:
Anthem
Blue Cross 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, some applications
that are done online are approved by Blue Cross within 24
hours.
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 make sure there are no
delays in getting you covered.
Effective
dates:
The
coverage can go into effect in as quickly as 24 hours, though
you risk being declined if claims are submitted before the
underwriting process is completed. You may request
an effective date any time the date after 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 Blue Cross that your coverage has been approved and
is in force.
Your
earliest possible effective date will be the day after Blue
Cross has received all the necessary documents and information
needed to process your application.
HSA Administrator:
Your
health savings account is totally separate from your health
insurance, and you may use any approved bank or trustee
as your HSA administrator. We recommend that you choose
one from our HSA administrator
page, where you can compare rates and features.
About
Anthem Blue Cross:
Anthem
Blue Cross has been serving the health care
needs of Californians since 1937. Blue Cross of California,
together with its branded affiliates, provides health care
services to more than 6.8 million members.
Anthem
Blue Cross 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
Blue Cross of CA agent.
CA License
#: 0E39302
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"Our
medical insurance is now costing less than half of what
it was before we got an HSA (we're saving over $3,500 a
year in premiums), and we can save federal-tax free."
I
very much appreciate what you have done for my wife and
I. HSA for America
offered us a great variety of plans to choose from.
Our medical insurance is now costing less than half of what
it was before we got an HSA (we’re saving over $3,500
a year in premiums), and we can save federal-tax free.
HSA
for America provides outstanding service.
Most other companies have you on hold and entering numbers
on the phone until you are completely fed up. While
you provide all the questions and answers. I did not
even have to ask questions - you have provided all the questions
and answers for me.
I
talk very favorably to my friends about your company.
Beryl
Sanders
Loomis, CA
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