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Depending on the plan and the state
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from Anthem for individuals and families.
Anthem Blue Cross and Blue Shield of Connecticut
provides health coverage as follows:
Which Anthem Connecticut health plan Is right
for you?
BlueCare
Direct (HMO)
BlueCare Direct is a health maintenance
organization (HMO) plan. That means benefits for
covered services are available when you use any
of the nearly 4,000 doctors, hospitals and other
health professionals that are part of the plan
network in Connecticut.
Century
Preferred Direct (PPO
Century Preferred Direct is a preferred
provider (PPO) health plan. That means you can
receive the highest level of benefits when you
use any of the 5,000 physicians and other health
care professionals
in the plan’s network.
Benefits are also available for care delivered
by health providers that are not part
of the
network, however benefits are often lower and
your out-of-pocket costs will be greater.
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The Basics – how your coverage works
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This comparison chart lists the benefits that would apply for each person on the policy. Your choice of deductible will affect your premium.
If you are looking for family coverage, please look at the family deductible. Once your family meets two times the individual deductible, no additional deductible amount will be due for that benefit period. (However, no one person can contribute more than their individual deductible amount to
the family deductible.)
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In-Network
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PPO Network of Providers. No gatekeepers or referrals
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Century Preferred Direct 80/20 PPO
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Century Preferred Direct 100 PPO
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Deductible Choices
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$250/$500
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$1,500/$3,000
$5,000/$10,000
$10,000/$20,000
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Out-of-State Benefits
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Yes
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Yes
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Out-of-Network Benefits
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Yes – subject to higher coinsurance
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Yes – subject to higher coinsurance
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Lifetime Maximum Benefit3
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$5 million
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$5 million
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The Details – the benefits and your share of the cost
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Covered Services - In-Network
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(Member is responsible for coinsurance amounts below after the policy deductible unless otherwise noted)
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Century Preferred Direct 80/20 PPO
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Century Preferred Direct 100 PPO
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Preventive Care
(including routine physicals)
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20% coinsurance after deductible
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0% coinsurance after deductible
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Office Visits
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20% coinsurance after deductible
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0% coinsurance after deductible
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Specialist Visits
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20% coinsurance after deductible
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0% coinsurance after deductible
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Lab/X-Ray
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20% coinsurance after deductible
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0% coinsurance after deductible
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Diagnostic Services
(MRI, MRA, CAT, CTA, PET and SPECT)
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20% coinsurance after deductible
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0% coinsurance after deductible
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Outpatient Surgery
(in a hospital or surgical-center)
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20% coinsurance after deductible
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0% coinsurance after deductible
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Hospitalization
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20% coinsurance after deductible
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0% coinsurance after deductible
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Emergency Room
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20% coinsurance after deductible
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0% coinsurance after deductible
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Vision Care
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$20 copay per visit
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$20 copay per visit
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Prescription Drugs
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Optional Coverage Available: $10 copay for generic drugs; $25 copay for Listed Brand Drugs; $40 copay for Non-listed Brand Drugs; $2,000 maximum per calendar year; Not subject to deductible.
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Lumenos® Health Incentive Account (HSA)
Plan
Our portfolio of Lumenos® plans
offers three choices for individuals and
families. You decide which one works best for
you. The Lumenos® Health Savings
Account (HSA) Plan is funded by your own
contributions, which may be tax-deductible. It
gives you an account called a Health Savings
Account, or HSA, which you can use to pay for
medical care and prescriptions; and which may
lower the amount you have to spend out of your
pocket.
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The Basics – how your coverage works
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This comparison chart lists the benefits that would apply for each person on the policy. Your choice of deductible will affect your premium.
If you are looking for family coverage, please look at the family deductible. Once your family meets two times the individual deductible, no additional deductible amount will be due for that benefit period. (However, no one person can contribute more than their individual deductible amount to the family deductible.)
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Deductible Choices
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Individual/Family
$1,250/$2,500
$2,500/$5,000*
$5,000/$10,000
Per covered person, per calendar year. Applies to services in- and out-of network combined
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Out-of-State Benefits
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Yes
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Out-of-Network Benefits
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Yes – subject to higher coinsurance
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Lifetime Maximum
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Unlimited In-Network; $1,000,000 Out-of-network
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The Details – the benefits and your share of the cost
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Covered Services - In-Network
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Preventive Care
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(including routine physicals)
No cost to member
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Office Visits
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No charge after deductible*
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Specialist Visits
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No charge after deductible*
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Lab/X-Rays
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No charge after deductible *
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Diagnostic Services
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(MRI, MRA, CAT, CTA, PET, and SPECT)
No charge after deductible*
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Outpatient Surgery
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(in a hospital or surgi-center)
No charge after deductible*
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Hospitalization
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Office Visit, Outpatient Hospital, Inpatient Hospital
No charge after deductible*
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Emergency Room
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No charge after deductible*
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Maternity Care
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Not covered
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Prescription Drugs
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No charge after deductible*
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Anthem Blue Cross and Blue Shield is the trade
name for the following:
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In Colorado:
Rocky Mountain Hospital and Medical Service,
Inc.
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Learn More >> |
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In Connecticut:
Anthem Health Plans, Inc.
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Learn More >>
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In Indiana:
Anthem Insurance Companies, Inc.
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Learn More >>
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In Kentucky:
Anthem Health Plans of Kentucky
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Learn More >>
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In Nevada:
Rocky Mountain Hospital and Medical Service,
Inc.
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Learn More >> |
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In Ohio:
Community Insurance Company.
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Learn More >>
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In Wisconsin:
Blue Cross Blue Shield of Wisconsin BCBSWi and Compcare
Health Services Insurance Corporation Compcare.
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Learn More >>
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Independent licensees of the Blue Cross and Blue
Shield Association
Serving residents and businesses in Indiana,
Kentucky, Missouri, Ohio, Wisconsin, Colorado,
Nevada, Connecticut, Maine, New Hampshire and
Virginia (excluding the city of Fairfax,
the town of Vienna and the area east of State
Route 123)
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Learn More >>
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