Why Purchase Health Coverage

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Why Purchase Health Coverage In today's world, health coverage protects you and your family from the high financial exposure that may accompany even common accidents or illnesses.  

A typical hospital stay (about four days and two follow-up visits) is now more than $29,000. By using a provider in our vast provider network, your financial responsibility will be decreased.

How You Save Money Using the Power of Blue We have negotiated discounts for you when you use a provider from our vast network. The Anthem Blue Cross network is among the largest in the state, consisting of more than 46,000 PPO physicians, 27,000 HMO physicians and 440 hospitals.   By using a network provider, you could save up to 30-40 percent on out-of-pocket expenses each time you or your family receives medical care.  

If you do not use a network provider, you not only pay a higher amount of the negotiated fee, you are also responsible for charges over and above the negotiated fee. That's why it pays to stay within the network.

Anthem Blue Cross-negotiated provider fees help PPO members save! Here’s a generic example that compares how relative costs might break down using an in-network v. out-of-network provider, assuming that the member’s annual deductible has been met and the annual out-of-pocket maximum has not been reached. 

 

     
  In-Network Out-of-Network
Plan pays
based on:		 Negotiated
Fees		 Customary &
Reasonable Fees

Provider's usual fee

$1,000

$1,000

Anthem Blue Cross negotiated savings

$400

  

Provider's negotiated fee

$600

$600

Anthem Blue Cross payment is applied*:

80% in-network

60% out-of-network

$480

$360

Member’s out-of-pocket cost is:

20% in-network*

40% out-of-network

$120

$640
 

plus in excess of negotiated fee rate

*percentages vary from plan to plan     From $1,000 to $120 in network, or $580 out of network! PPO members can save a lot just by having Anthem Blue Cross coverage, and even more when they choose participating in-network providers with Anthem Blue Cross negotiated savings.