Category Archives: Anthem PPO

Anthem Drops Covered California In Most Regions

Anthem drops Covered California in most areas, and has joined our Wall of Shame, according to a recent memo to its agent community. Anthem Blue Cross’ latest decision is more extreme than last year’s move to exit individual PPO plans (see earlier story).

In some  California counties, Blue Shield is the only insurer to offer a true PPO plan, adding credibility to their Not-For-Profit status and commitment to support the future of the ACA. (read the entire article from Coverage California). Conversely, Anthem is a for-profit company and is listed on the New York Stock Exchange as WellPoint.

Anthem drops Covered California in most counties

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Why is Anthem withdrawing from the exchanges in California?

(In Anthem’s own words…)

“While Anthem is reducing its 2018 Individual plan offerings in California, it is not withdrawing from the exchanges. We are pleased to be participating in three key areas”

“On-exchange and off-exchange EPO plans at all metal levels will be offered in three regions of Northern California…”

To learn more or to receive free assistance, complete and return a Covered California Agent Designation form.   There is no cost to you! A licensed agent will answer your questions and help you find a replacement plan for the upcoming open enrollment season. Start the process early, as 150,000 members will be making phone calls to find a different Covered California plan. (Licensed No. 0563986)

Anthem Drops Covered California- Get Your Free List of Alternate Plans

(click the logo below for an online quotation of PPO plans in your region or complete the agent designation form and fax it to (408) 255-8105 or via email info@derendinger.com. (Licensed No. 0563986))

Anthem Drops Covered California in most regions

Free Consultation  –  408-252-7300  –  

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Helping Northern California Individuals & Families since 1959.

Affordable Health Insurance for California Residents

It is embarrassingly ironic that the Covered California news page refers to “Stability” on the health exchange.  We can only imagine the impact of 150,000 Anthem subscribers trying to get assistance in a very tight window of time. So move quickly to reserve your space for free agent assistance: Just complete the following form and fax it to 408-255-8105 or email it to info@covered-ca.com.  It’s free!

 Covered CA Agent Delegation Form

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License 0563986

Anthem PPO Plans Discontinued

Anthem PPO Plans Discontinued Golden_Gate_Bridge_Yang_Ming_Line_mini anthembcca_lCalifornia-based Anthem Blue Cross announced all individual and family Anthem PPO Plans discontinued on January 1st will be replaced by an EPO plan.  One rumor suggests this is an HMO plan, in disguise.  Are such rumors true or false?

Let’s consider Anthem’s statements for the changes coming coming to California individuals in 2017:

  1. All 2016 Tiered PPO plans will be discontinued
  2. PCP selection required for all plans
  3. Replacement plans do not have out-of-network coverage (except for urgent care or in the case of an emergency)

All 2016 Anthem PPO plans discontinued

Are you covered under a California-based individual or family plan from Anthem Blue Cross. The bad news is out: Your health plan is going away in 2017, and now is the time to take action, before open enrollment closes.  For most California individuals, this is December 15th, assuming you want a January 1st effective date. Read additional features below

 Opinion:  Blue Shield of California seems committed to supporting the good features of the Affordable Care Act.  In many California counties, Blue Shield is the only insurer to offer a true PPO plan, adding credibility to their Not-For-Profit status and commitment to support the future of the ACA. (read the entire article from Coverage California)

Blue Shield and the Future of the ACA

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Primary Care Physician will be required for all individual Anthem health plans

If you are covered under a California-based Anthem Blue Cross plan discontinued in 2017, you will be impacted whether you purchased your plan directly from Anthem or through the Covered California exchange.  These plans will be replaced by a new EPO product, which (like an HMO), require you to select a PCP (primary care physician) from Anthem’s list of participating providers.  Caution:  This list excludes Sutter and PAMF providers in most situations.  If you require a plaAnthem Blue Cross PPO discontinuedn that covers PAMF/Sutter providers, now is the time to take action, before open enrollment ends. At the time of this writing, Blue Shield of California was still contracted with most PAMF and Sutter Doctors.

No Out-of-network Coverage

If you are currently covered under an Anthem Blue Cross PPO plan discontinued and replaced by the new EPO on January 1st, you will lose out-of-network coverage (except for emergencies and urgent care.

EPO plans operate like a PPO, but do not have out-of-network coverage except for urgent care or in the case of an emergency.

Should you keep the EPO plan or switch to Anthem’s competitor, Blue Shield of California Quote?  The advantage of Anthem’s product is its low cost.  Of course, it is low cost because Anthem is taking away many of your health care options.  A big decision point is whether or not you are prepared to make the commitment to a Pathway network Primary Care Physician by “selecting” one for each family member:  Search for them here:

In summary, Anthem PPO plans discontinued and replaced by an EPO reduces your ability to seek different specialists and providers for your family’s care.  However, the rumor is false: The EPO is not the same as an HMO, but it’s a pretty close cousin.  For example, losing out-of-network coverage, and choosing a PCP are both hallmarks of an HMO.

Bottom-line, it’s your decision unless you do nothing:  Because all Anthem PPO plans discontinued will be transferred to the EPO.  If this bothers you, then take control and check out Blue Shield’s PPO.

In many California counties, Blue Shield is the only insurer to offer a true PPO plan, adding credibility to their Not-For-Profit status and commitment to support the future of the ACA. (read the entire article from Coverage California)

Blue Shield and the Future of the ACA

Click & Quote from Blue Shield’s Secure Server and request our free Survey of the Best Dental Insurance for families