Anthem Medical Plans

Our medical insurance provider is Anthem Blue Cross Blue Shield, and our prescription coverage is provided through Carelon.

Network:  BLUE ACCESS

Your health and the health of your family are important! Clermont County recognizes that families have different needs and priorities, that’s why we offer three excellent medical plans to choose from.

Choice of plan designs:  Premium Copay; Basic Copay; and HDP/HSA (health savings account).

Premium Copay Plan In-Network benefits include:

      • Primary Care Physician Office visit (including Internists, Pediatricians): $10 Copay
      • Virtual Dr. Visit (including mental health): $0 Copay
      • Specialists Office visit: $50 Copay
      • Urgent Care Visit: $25 Copay
      • Emergency Room:  $300 Copay
      • Deductible $2,000 per person / $4,000 maximum per family
      • Maximum-Out-of-Pocket (MOOP):  $5,000 per person /maximum = $10,000 per family.
      • Rx Copay = Retail: $15;/$50/$70; 90 day Scripts Mail Order or RxM90 Pharmacy: $30/$100/$140

Basic Copay Plan In-Network benefits include:

      • Primary Care Physician Office visit (including Internists, Pediatricians): $35 Copay
      • Virtual Dr. Visit (including mental health): $0 Copay
      • Specialists Office visit:  $70 Copay
      • Urgent Care Visit: $75 Copay
      • Emergency Room:  $350 Copay
      • Deductible $5,000 per person / $10,000 maximum per family
      • Maximum-Out-of-Pocket (MOOP):  $6,000 per person /maximum $12,000 per family.
      • Rx Copay = Retail: $15;/$50/$100; 90 day Scripts Mail Order or RxM90 Pharmacy: $30/$100/$200

HDP/HSA In-Network benefits include:

      • Member pays 100% of the UHC provider contract rate until satisfying the deductible, including prescription drugs (Rx).
      • Deductible:  $3,400 per person / $6,800 maximum per family
      • Member pays 10% co-insurance after meeting deductible, up to the MOOP.
      • MOOP (Maximum-Out-of-Pocket):  $4,000 per person / maximum = $8,000 per family
      • Can be paired with an HSA and/or a Limited FSA (dental & vision only).
      • Learn about  HSA’s  here.

Compare the SBC’s and SPD’s for each plan to understand the difference between the plans.

Anthem BlueCross BlueShield  Customer Service – 1-855-603-7982 Website: Anthem Blue Cross Blue Shield: Health Insurance, Medicare & More

Questions – Contact the Benefit Resource Center at 855-874-0829 or email them at BRCMidwest@usi.com Monday through Friday 8:00 am to 5:00 pm Eastern & Central Standard Time