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Anthem Medical Plans

NortonLifelock offers three medical plans with Anthem:

  • Anthem Health Savings Account (HSA) Plan
  • Anthem PPO Plan
  • Anthem PPO Plan 500
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Deductibles and Out-of-Pocket Maximums

Your individual deductible is the amount you need to pay each year before your plan starts paying. Your family deductible is the amount your family needs to pay each year before your plan starts paying (applies to medical and behavioral health). For the Anthem HSA Plan, the deductible applies to combined medical, behavioral, and prescription drug expenses.

The deductible must be satisfied each calendar year before the plan starts paying; however, when you go in-network, preventive care is paid at 100% and is not subject to the deductible.

The amount you pay for all covered expenses counts towards both the in-network and out-of-network deductibles. For example: if you have an in-network claim for $100.00 and an out-of-network claim for $150.00, you will have satisfied a total of $250.00 toward your deductible.

The three Anthem plans treat deductibles differently:

HSA Plan

The Anthem HSA and Plan has a "collective" or "family" deductible, which means that all family members contribute towards the family deductible. The plan cannot pay an individual's claims until the total family deductible has been met, even if he or she has met the individual deductible. Keep in mind that for each of these plans, NortonLifelock deposits a specific dollar amount into a special account for employees enrolled in the plans to "share" the cost of the total family deductible.

On both plans, the deductible is the same amount whether you are going in- or out-of-network. You have one deductible amount to meet regardless of whether the services were in- or out-of-network services.

PPO Plan

On the PPO plan has an "individual" deductible, meaning that after each family member meets his or her individual deductible, covered expenses for that family member will be paid based on the coinsurance level specified by the plan. Or, after the family deductible has been met, covered expenses for each eligible family member will be paid based on the coinsurance level specified by the plan.

On the PPO Plan, the out-of-network deductible is higher than the in-network deductible. Any amount you satisfy toward your deductible will count toward both the in- and out-of-network deductibles; however, you will have a higher amount to satisfy out-of-network before the plan starts paying.

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