The SmartSense Plus PPO offered by Anthem Blue Cross is one of the most popular plans in the portfolio due to a good marriage of both affordability and quality of benefits. The SmartSense Plus offers consumers three deductible choices: $2,000, $3,500 & $6,000. The deductible is the only variable, as the mechanics of the plan are the same. With the SmartSense Plus you are covered for unlimited doctor visits. For Preventative benefits like a PapSmear, Wellbaby/WellChild or a basic checkups youýre covered at 100% with no cost sharing. For regular sick visits the deductible is waived for the first three visits per family member per calendar year; additional visits reduce your deductible.
The good thing is that by visiting an Anthem Blue Cross participating provider you can save money even if you havenýt satisfied your deductible. For example- letýs say you visit the doctor for a sick visit for a fourth time in a calendar year and the doctorsý office regular charge is $100. The Anthem Blue Cross contracted rate might be $70, if that is the case then you would save $30 because of the PPO predetermined negotiated rate. Furthermore, your deductible is now $70 less: for example, if you have a $2,000 deductible your deductible is now $1,930; you just keep reducing your deductible throughout the year, and if you donýt go you donýt pay. If you do in fact satisfy your deductible then all covered benefits are paid at 70%.
Now if you go to the doctor for an office visit and Anthem Blue Cross allows $70 you just pay $21 (30% of $70). The great peace of mind of this plan is that Anthem will pay your bills at 100% if your 30% cost sharing ever reaches $3,500, and this benefit has no limit! The SmartSense Standard PPO plans covers generic prescriptions for a $15 copayment. Name brand drugs are covered too but a $7,500 deductible helps keep your premium down. To help you customize your SmartSense plan, there is an name brand drug upgrade option that will lower your deductible to $500. Bottom line is that no matter which deductible you choose you have the peace of mind of knowing you have quality healthcare that will be there when you need it.
If you any have questions regarding SmartSense PPO don’t hesitate to shoot us an email: [email protected] or call us toll free at 1-800-356-3615.