Be part of the solution Our Lumenos plans help keep you more informed, so you can get the most from your health care benefits.
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1 Be part of the solution Our Lumenos plans help keep you more informed, so you can get the most from your health care benefits CAMEN LG
2 Get coverage that helps you choose wisely, spend wisely, and live healthy You don t have to settle for bare-bones benefits to save money. Our Lumenos plans give you access to a wide range of benefits, including preventive care coverage. You get a plan that puts you in the driver s seat, with more control over your health care dollars. A plan that helps you make more informed choices. A plan that s no temporary fix, but a sensible, long-term solution. Choose a better plan for better health Each Lumenos consumer-driven health plan starts with a health account to help you pay for covered medical services and prescriptions. Nationally recommended preventive care is covered up to 100%. Plus, you get traditional health coverage that kicks in after your deductible to help protect you further. That s just for starters. Our Lumenos plans also come fully equipped with health tools and programs that help support a healthy lifestyle and help you make more informed decisions about your health care. And you can even earn rewards for your healthy choices. Enjoy access to more doctors and hospitals at home and around the world Through the Blue Cross and Blue Shield Association s BlueCard program, you have access to more than 90% of hospitals and 80% of doctors across the country. 1 You also have access to providers around the world through the BlueCard Worldwide program. Plus, we ve negotiated discounts with network providers that may help you stretch those health care dollars.
3 Get customer service that s focused on you Everything we do is aimed at giving you a superior customer experience. We want to help you get the information and answers you need quickly, efficiently and correctly. The first time. To access your personalized services and resources online, just register at anthem.com/ca. It s fast, easy and secure. To speak with Member Services, just call toll-free Benefit from integrated plans that put information at your fingertips Our Lumenos plans are seamlessly integrated to give you a smooth experience. From claims history to account activity to wellness programs, you can get all the information and tools you need to stay on top of your health and your health account at anthem.com/ca. So you ll always have the information you need when you need it. A health plan that s different, yet familiar No doubt about it, our Lumenos plans are different. For one thing, each is coupled with a health account, which may be new to you. But these plans feel familiar, too. That s because they all include traditional coverage you can count on. Here s how your Lumenos plan works: Your Health Incentive Account Plus (HIA Plus) helps pay for covered medical services and prescriptions. The health account works much like a bank account. You use its funds to pay for covered medical services and to help meet your deductible. Your HIA is funded by an annual allocation from Anthem and funds are always used for first-dollar coverage. Any unused funds roll over from year to year and can help reduce future out of pocket expenses when you stay with this employer-sponsored plan. Plus, you can earn additional funds as rewards for healthy behaviors. Preventive care helps keep you healthy. The plan pays up to 100% for covered preventive care services received from network providers. There are no funds taken from the health account, and there are no additional out-of-pocket costs. Check out Your Lumenos plan details chart on the following page for more information. Traditional health coverage kicks in after your annual deductible. After you meet your annual deductible, your traditional health coverage (similar to a PPO or HMO) helps protect you from large health care expenses. Your annual out-of-pocket maximum limits the amount you pay during the plan year.
4 LUMENOS IN A NUTSHELL: Take advantage of your preventive care benefits. Lumenos plans cover up to 100% of covered preventive care services when you see a network provider. Visit any doctor even a specialist without a referral. Choose from a large network of providers for greater savings. Or, go out of network and share more of the cost. The choice is yours. Find a helping hand. From researching health topics to calling in a health coach, you ll find a wealth of tools, support and resources at anthem.com/ca.
5 Your Lumenos plan details Step 1 Step 2 Step 3 Step 4 HIA Plus Annual contribution: $1,500 Single $3,000 Family Unused dollars rollover each year. If you leave the plan unused funds are returned to Anthem. Deductible: $3,000 Single $6,000 Family Preventive care: 100%, no deduction from your HIA Plus for network providers Traditional health coverage after deductible: 0% coinsurance for network providers 30% coinsurance for out-of-network providers Plan pays 100% of eligible expenses if you reach your annual out-of-pocket maximum. Getting the care you need is easy 1. Just show your ID card when you visit a network provider to receive our discounted rate. 2. If you have funds in your health account, the cost for covered services and prescriptions will automatically be deducted from your account. You won t need to pay anything at the time of service. 3. If you ve used all of your health account funds and have not met your deductible, you ll pay the discounted rate for services and prescriptions out-of-pocket until you meet your annual deductible. 4. Once you ve met your annual deductible and your traditional health coverage begins, you ll pay the appropriate coinsurance or prescription copay up to your plan s annual out-of-pocket maximum. If you have met your annual out-of-pocket maximum, the plan will pay 100% of the cost of your covered services, up to the allowed amount. (See your Plan Summary for details.)
6 Enjoy a healthier health plan Compared to people with standard health plans, consumer-driven health plan members are more likely to look for ways to manage their health and health care spending. 3 Lumenos gives you the resources to do it. JOIN SAVVY HEALTH CARE CONSUMERS Lumenos members are more likely to use network providers, get preventive care and do their homework before making a health decision. 2 Our support tools and programs can help you make healthy, money-saving choices. And you can feel secure about relying on coverage from a sound and stable company. Tap into tips, tools and programs that can help improve your health outlook at anthem.com/ca. See your account balance, view claims and find health information. Find network doctors, hospitals, pharmacies and other health care professionals with our online directory. Recruit a health expert Health coaching programs work with a nurse or health coach to help manage high blood pressure, high cholesterol, lower back pain and other common concerns. You could earn rewards for enrolling and graduating from the program. Healthy Lifestyles programs participate in a program to quit tobacco or manage your weight with personalized support and education. Adopt a healthier lifestyle and you could earn rewards in your health account. Future Moms get education and information that can help get your pregnancy and your baby off to a healthy start. Extra help is available for high-risk pregnancies. 24/7 NurseLine make a toll-free call to talk to a registered nurse anytime you have general health questions or need guidance with critical health concerns. Tackle chronic conditions with personal support: ConditionCare helps you manage chronic conditions like asthma, diabetes, heart failure, coronary artery disease (CAD) and chronic obstructive pulmonary disease (COPD). ComplexCare offers the extra support you need when you re coping with complex or multiple health conditions. Get money-saving discounts of up to 50% on health-related products and services including health clubs, frames and lenses, maternity must-haves and alternative therapies.
7 Better health is your greatest reward. But a few extra dollars can help, too. Earn extra dollars in your health account to reward these healthy behaviors: Complete or update the MyHealth Assessment and earn $50. Enroll in a health coaching program and earn $100. Graduate from a health coaching program and earn $200. Complete the Healthy Lifestyles: Tobacco-Free program and earn $50. Complete the Healthy Lifestyles: Healthy Weight program and earn $50. You and your covered family members may be eligible. Check your plan summary for details and eligibility requirements.
8 To learn more, visit anthem.com/ca or call toll-free Blue Cross and Blue Shield Association website: Blue Cross and Blue Shield System Facts, 2 WellPoint Member Engagement Study, The 2008 EBRI Consumer Engagement in Health, 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 licensees of the Blue Cross Association. ANTHEM, LUMENOS and 360 Health are registered trademarks of Anthem Insurance Companies, Inc. The Blue Cross name and symbol are registered marks of the Blue Cross Association.
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