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Connect with a healthcare partner
committed to making you feel:
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Covered
by an exceptional
network of providers with
top patient-ratings
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Protected
by having
access to emergency care
across the U.S.
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Confident
by
knowing
what you'll pay before
visiting the doctor
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Helping you save
We decreased your copay for
primary care visits from
$30
to
$25
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| Anthem Blue Cross Select HMO basics
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Free preventive care
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Predictable out-of
-pocket costs
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No annual deductible
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Access to the Mail Order
Pharmacy program
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Residents of the following counties are eligible for coverage:
Imperial, Kern, Los Angeles, Orange, Riverside, San Bernadino,
San Diego or Ventura
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Provider Finder
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Select
Basic search as a guest and follow the prompts using the following responses:
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Select the type of plan or network
Medical Plan or Network (may also include dental, vision, or pharmacy benefits)
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Select the state where the plan or network is offered
California
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Select how you get health insurance
Medical (Employer-Sponsored)
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Select a plan or network
Select HMO
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Select
continue to search for network care providers.
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Close Window
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| What you pay for common services
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| Benefit
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Anthem Blue Cross Select HMO
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| Preventive care services
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No copay
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| Non-preventive primary care providers
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$25
per office visit
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| Specialists
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$40
per office visit
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| Virtual doctor visits through the
Sydney Health App**
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No copay
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| Urgent care centers
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$30
per visit
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| Retail health clinic
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$30
per office visit
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| Maternity care office visits
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No copay
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| Infertility services
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Check Plan brochure for types of coverage
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| Inpatient hospital
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$250
per day for a maximum of 4 days
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| Outpatient hospital
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$250
per visit for surgical admissions or
$40
per visit for other services
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Surgery
Professional Services
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No copay
unless performed during an office visit, then
$25
per office visit to your
primary care physician (PCP) or
$40
per office visit to a specialist
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| Emergency care
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$200
per emergency room visit
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| Lab, X-ray, and other
diagnostic tests
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No copay
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| Advanced imaging procedures
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$125
per test
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| Chiropractic care
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$15
per office visit
20 visits
per calendar year
When you see a chiropractor in the American Specialty
Health Plans of California, Inc. (ASH Plans) network
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Catastrophic protection
Your out-of-pocket maximum
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$3,000
Self + One:
$6,000
Self & Family:
$6,000
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| Prescription drug coverage
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| Anthem Blue Cross Select HMO
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| Level 1 Retail Pharmacies (up to a 30-day supply at a Plan pharmacy)
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| Tier 1
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$10
copay
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| Tier 2
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$50
copay
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| Tier 3
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$80
copay
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| Tier 4
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25%
of our allowance ($250 maximum per prescription)
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| Level 2 Retail Pharmacies (up to a 30-day supply at a Plan pharmacy)
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| Tier 1
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$20
copay
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| Tier 2
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$60
copay
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| Tier 3
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$90
copay
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| Tier 4
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25%
of our allowance ($250 maximum per prescription)
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| Home Delivery Pharmacy
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| Tier 1
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$20
copay
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| Tier 2
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$100
copay
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| Tier 3
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$160
copay
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| Anthem Blue Cross Select HMO Premium
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Enrollment Code
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Biweekly
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Monthly
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| Self
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B31
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$94.47
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$204.68
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| Self + One
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B33
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$204.14
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$442.31
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| Self & Family
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B32
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$224.93
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$487.35
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*You must stay in the network to receive care.
**Virtual doctor visits may also be accessed through
LiveHealthOnline.com without a copay. Virtual care from your own doctor or another healthcare provider in the network may have a separate copay.
Anthem Blue Cross is the trade name of Blue Cross of California. Independent licensee of the Blue Cross Association. Anthem is a registered trademark of Anthem Insurance Companies, Inc.
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| Anthem Blue Cross Select HMO will not participate in the Postal Service Health Benefits Program. Current members are still covered through 2024. Please
visit OPM for information on coverage options available to you.
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Close Window
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