About Anthem PPO Health Insurance


Anthem Blue Cross and Blue Shield offers Preferred Provider Organization (PPO) health plans for individuals and families. Blue Cross and Blue Shield define PPOs as "an arrangement designed to supply health care services at a discounted cost by providing incentives for members to use designated health providers." Unlike Health Maintenance Organizations, or HMOs, those enrolled in PPOs may also receive coverage for services provided by health care professionals who are not in the particular PPO network.


Anthem Blue Cross and Blue Shield PPO plans are available in California, New York, Colorado, Georgia, Nevada, Missouri, Ohio, Indiana, Connecticut, Kentucky, Virginia, Wisconsin, New Hampshire and Maine. In certain states, the company may do business under a different name, such as Empire State Blue Cross and Blue Shield in New York State.

Individual Short-Term PPO Plans

Anthem Blue Cross and Blue Shield offers individual short-term PPO plans, designed for those beginning new employment with a waiting period before becoming eligible for their employer's health care plan. In 2011, the short-term PPO plan offers deductibles ranging from $200 to $2,500, with coverage varying from one to six months. Due to the limited time period, past health conditions are ineligible for coverage. Only those health conditions beginning during the coverage period are eligible.

Lumenos Plans

Anthem calls its Lumenos Plans "the future of health care coverage." These plans emphasize preventative care, and exams and screenings do not incur deductibles. Consumers may choose from the Lumenos Health Savings Account (HSA) plan, funded through tax-advantaged contributions. Federal tax does not need to be paid on these contributions as long as money is spent only on health care. The Lumenos Health Incentive Account is also funded by reward credits, which add money to the HSA accounts for completing Anthem programs such as Healthy Weight and Tobacco-Free. The HIA Plus Plan includes quarterly contributions by Anthem.

Individual PPO Plans

Anthem offers several regular individual PPO plans for members. The ClearProtection Plan features a choice of deductibles and monthly payment plans, including prescription drug coverage but excluding maternity benefits. The Premier Plan, designed for families with young children, also includes preventative care coverage. The PPO Share Plan, also recommended for families, include prescription drug coverage and offers maternity coverage. SmartSense offers lower-monthly rates based on choice of deductibles. Younger consumers may prefer the no-frills Tonik plan. The RightPlan PPO40 has no deductibles, and co-pays for doctors office visits are $40 as of 2011.

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