On this plan, you have the freedom to see any provider of your choosing, but will pay less when seeking treatment within the Anthem Blue Cross network. With an individual deductible of $1,000, you pay more in payroll contributions but less out-of-pocket for services than the High Deductible Health Plan.
For in-network office visits and prescription drugs, you pay a set copay.
For services other than in-network office visits and prescription drugs, you pay the full amount billed until you meet the deductible, then you pay a 15% coinsurance and the plan pays 85% until you reach the annual out-of-pocket maximum.
On the PPO plan, deductible and out of pocket maximums are embedded, which means that claims paid towards an individual member’s $1,000 deductible will switch to coinsurance once the deductible is satisfied, even if on a plan with family members.
To cover out of pocket costs, you can also elect to enroll in a Flexible Spending Account.