Having the right health care is priceless but it shouldn't and doesn't have to cost you an arm and a leg. We are committed to making sure you have access to the best health care providers available and work hard to provide exceptional care at an affordable price.
Lina Lieu Nguyen Ins Agcy Inc is an authorized broker in California for Anthem Blue Cross.
At Anthem Blue Cross, we are committed to improving health care for all of us. After all, we've been here for over 60 years addressing changes in the healthcare system and making sure Californians can get access to the care they need at a price they can afford. From our vast doctor network to alternative medicine coverage to personalized plans, toll-free help lines and member focused services, we are California's leading health benefits company.
Anthem Blue Cross is the trade name of Blue Cross of California. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licenses of the Blue Cross Association. ® ANTHEM is a registered trademark. The Blue Cross names and symbols are registered marks of the Blue Cross Association.
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Looking for health coverage? Anthem Blue Cross offers Member-focused service, a wide choice of plans and doctors, financial strength and affordable rates.
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Since Health Insurance is confusing sometimes, I have included a brief glossary below that discusses some terms you might come across as you shop around.
Federal legislation that requires employers with 20 or more employees to offer employees (and/or dependents) to continue coverage under the group plan for 18 to 36 months.
The percentage of covered expenses an insured individual shares with the carrier. (i.e., for an 80/20 plan, the health plan member's co-insurance is 20%.) If applicable, co-insurance applies after the insured pays the deductible and is only required up to the plan's stop loss amount. (see "stop loss" below)
Co-pay/Co-payment
The amount an insured individual must pay toward the cost of a particular benefit. For example, a plan might require a $10 co-pay for each doctor's office visit.
Deductible
Amount of covered expenses that must be paid by subscriber before coverage begins. Unless otherwise noted, deductibles are on a calendar year basis.
HIPAA
Federal legislation requiring all insurers who offer individual coverage to provide their two most popular plans on a guaranteed acceptance basis to all applicants whose group coverage (including COBRA) ended within 63 days prior to application for coverage.
An alternative to commercial insurance that stresses preventive care, early diagnosis and treatment on an outpatient basis. HMOs are licensed by the state to provide care for enrollees by contracting with specific health care providers to provide specified benefits. Many HMOs require enrollees to see a particular primary care physician (PCP) who will refer them to a specialist, if deemed necessary.
Network
A group of doctors, hospitals and other providers contracted to provide services to insured individuals for less than their usual fees. Provider networks can cover large geographic markets and/or a wide range of health care services. If a health plan uses a preferred provider network, insured individuals typically pay less for using a network provider.
Out-of-Network
describes a provider or health care facility which is not part of a health plan's network. Insured individuals usually pay more when using an out-of-network provider, if the plan uses a network.
Out of pocket maximum
The amount of expenses incurred by an individual at which the plan pays 100% of covered expenses. Amounts in excess of scheduled allowances and other non-covered expenses do not count toward the out of pocket maximum. Family out of pocket maximums can be aggregate (the total expenses by all family members added together) or separate (a certain number of family members must reach their individual out of pocket maximum to initiate the benefit). Quotes display family aggregate out of pocket maximums as a fixed dollar amount and separate out of pocket maximums as the number of out of pocket maximums required per family. Deductibles are included in the out of pocket maximum.
Preferred Provider Organization (PPO)
A network or panel of physicians and hospitals that agrees to discount its normal fees in exchange for a high volume of patients. The insured individual can choose from among the physicians on the panel.
Schedule of allowable charges
Pre-determined amount the carrier will pay for services provided by non-contracted provider. Generally, carriers set the allowable fee schedule at the same level as the negotiated rate for contracting providers. Since there is no contractual obligation on the part of non-contracting providers to accept the fee schedule, the customer is responsible for all charges in excess of the schedule.
Short-term medical
Temporary health coverage for an individual for a short period of time, usually from 30 days to six months.
Stop-loss
The dollar amount of claims filed for eligible expenses at which the insurance begins to pay at 100% per insured individual. Stop-loss is reached when an insured individual has paid the deductible and reached the out-of-pocket maximum amount of co-insurance.
UCR
Short for usual, reasonable and customary, which is a method that some carriers use to determine allowable charges for non-contracted providers. Usual means the charge that a given provider usually charges, reasonable takes into account extenuating circumstances, customary means what is generally charged in the geographic area. Different carriers have various methods of calculating UCR.
