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Anthem Blue Cross and Blue Shield Health Insurance Review

I have peace of mind knowing that my spouse and I are covered under the Anthem Blue Cross and Blue Shield Health Insurance policy. If either of us gets sick, I know I will be in good hands. I receive my health insurance through my employer. I pay $170 bi-weekly for an employee and spouse plan. However, my employer has an incentive. If I participate in the health and wellness incentive, which I do, I receive $20 off the price of my insurance premium bi-weekly. There are three different plans to choose from, single, employee and spouse, or family (which includes children under the age of 18, or a child over the age of 18 up to the age of 24, if they are a full-time student).

Our deductible is a bit high, for my spouse and me it is $1,650 a year. However, the deductible is based on an employee's earnings; I have one of the lower deductibles. Once the deductible is met, then the co-pay is 80/20% for in network, and 60/40% for out of network. We have always used in network as there is always a doctor to be found.

If anything serious happens to either my spouse or me that require a lengthy hospital stay, it will not cost us an arm and a leg. After the deductible, the yearly out of pocket expense would only be $4,950. The out of pocket expense is per plan, not per person. Our lifetime benefit is $2,000,000. A hospital stay can get costly, but it does not seem likely it would amount to the lifetime benefit.

In addition to what has already been mentioned, other benefits include:

  • Free physical exams, immunizations and inoculations up to $300 per year.
  • Private Duty Nursing for 42 visits per year
  • Skilled Nursing Facility for a maximum of 60 days per illness or injury
  • Physical Therapy includes 25 visits per year
  • No limit of number of days of an inpatient hospital stay
  • Free choice of any licensed legally qualified MD or hospital
  • Chiropractic services of up to 12 visits per year

Additional benefits include Home Health Care, Hospice Care, Durable Medical Equipment, and Behavioral Health/Alcohol and Substance Abuse.

I live in Atlanta, Georgia and my insurance is a PPO plan. This is the only plan available from my employer. The last two years I was enrolled in an HMO plan. With the HMO plan I had to travel an hour and a half from my home in order to see a specialist. With the PPO plan, I do not have that inconvenience. I can now go anywhere I want to see a doctor or specialist, which is a tremendous time saver.

I have not had the need to use my insurance as of yet, but my spouse will be using it for the first time to have oral surgery done. From the time his dentist referred my spouse to a specialist, to the time that the surgery provider contacted Anthem insurance, everything went smoothly.



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