Coverage to Build a Foundation of Good Health
At Olympic Steel, we understand the importance of good health as the foundation for a productive life at home and at work. That is why we offer medical and prescription coverage, administered by Anthem Blue Cross Blue Shield, to fit your needs and budget.
Use Your Coverage Wisely – Urgent Care vs Emergency Room
Everyone wants to save time and money and sometimes it takes a little legwork to do both. One way is to be aware of the appropriate usage of the Emergency Room versus using an Urgent Care center.
Urgent Care is for minor illness and injuries such as sprains and cuts, colds and the flu. The Emergency Room is for true emergencies such as broken bones, chest pains, and excessive bleeding…any condition that may be life-threatening or that will cause permanent damage without immediate and a higher level of care.
On average, the cost of the Emergency Room is five to eight times higher than the cost of Urgent Care and the average wait time is several hours instead of minutes. Why pay more and wait more for the same outcome?
Anthem PPO Plan
How it Works
The Anthem BCBS medical plan is a Preferred Provider Organization (PPO) which means Anthem BCBS has contracted with a network of healthcare providers, including facilities, to provide better pricing for those who seek care within the network.
In-Network Medical Plan FAQs:
- Copays:
-
- Office visits, ER, Urgent Care and Generic prescription drug all have flat copays and are not subject to the Plan deductible;
- Copays do not count toward your deductible
- Copays do accumulate toward your annual out-of-pocket maximum
- The annual deductible will apply to services such as Inpatient hospital stays, Outpatient services and some diagnostic testing
- Once the deductible is met, the Plan’s will begin to pay benefits at 80% (network)
- Your coinsurance amount after the deductible is 20%; once your annual out of pocket maximum is met the Plan will pay covered services at 100% for the rest of the plan year (network).
Prescription Coverage through Anthem BCBS/Carelon
If you enroll in the medical plan, you are automatically enrolled in prescription drug coverage. The pharmacy benefits manager is Carelon, Anthem BCBS’s pharmacy partner. To find out which drugs are covered, refer to the National Drug List found to the right side of this window or contact a customer service representative at 1-833-760-7890.
Some medications may require prior authorization from Carelon before your prescription will be filled. Your doctor should contact Carelon to initiate a prior authorization request.
Visit www.anthem.com if you have questions regarding your medical or prescription coverage.
Resources
PPO Plan Details
| Anthem Blue Access PPO | In-Network | Out-of-Network |
| Deductible | $1,000 Single/$3,000 Family | $2,000 Single/$6,000 Family |
| Out-of-Pocket Maximum | $5,000 Single/$10,000 Family | $5,500 Single/$11,000 Family |
| Coinsurance | 20% | 40% |
| Deductible Type | Embedded | |
| PCP Office Visit Copay | $10 | Deductible; 40% |
| Specialist Office Visit Copay | $25 | Deductible; 40% |
| Preventive Visits | Covered 100% | Deductible; 40% |
| Virtual Visit Copay – PCP | $0 | Not Covered |
| Emergency Room Copay | $200 | |
| Urgent Care Services Copay | $50 | Deductible; 40% |
| Prescription Drug | ||
| Deductible – Rx | N/A | |
| Prescription Drugs Retail | $10 / 25% / 50% | |
| Prescription Drugs Mail Order | $10 / 25% / 50% | |
Please refer to the benefits summary for more information.
To save money on office visits, use an In-Network Primary Care and Specialist doctors. To save money on labwork, use a lab in the Preferred Lab Network. Log onto anthem.com/find-care/ to search for Providers, Hospitals, or Other Care Providers. Or, call Anthem customer service for assistance at 1-833-952-2042.
Anthem HDHP Plan
A High Deductible Health Plan is a medical plan that typically has a much higher deductible than a traditional PPO plan. Eligible healthcare services are not payable by the insurance plan until you meet your annual deductible. Once the deductible is met, the plan will pay benefits according to the coinsurance amount and you will pay the balance. Once the sum of your deductible and your coinsurance amounts meet the annual out-of-pocket maximum the plan will pay eligible expenses at 100% for the rest of the plan year.
To help manage plan expenses, you are eligible to establish a Health Savings Account. You fund the account with pre-tax dollars from your paycheck or, if you add contributions on an after-tax basis, you can claim them on your healthcare annual tax return. Money in the HSA is to be used to offset a higher deductible and other IRS qualified expenses. If you don’t have expenses, the account serves as a tax-free savings vehicle for the future.
In-Network Medical Plan FAQs:
- The plan pays 100% for in-network preventive care.
- You pay all non-preventive care costs, including prescription drugs, up to the annual deductible. The annual deductible is $3,300 for Individual and $6,600 for Family when you use in-network providers.
- Once you have met the deductible, you will pay coinsurance for services received. When you use in-network providers, your coinsurance cost will be 20% for individual and family.
- Your coinsurance amount after the deductible is 20%; once your annual out of pocket maximum is met the Plan will pay covered services at 100% for the rest of the plan year (network).
Resources
HDHP Plan Details
| Anthem Blue Access HDHP | In-Network | Out-of-Network |
| Deductible | $3,300/$6,600 | $6,000/$12,000 |
| Out-of-Pocket Maximum | $6,000/$12,000 | $12,000/$24,000 |
| Coinsurance | 20% | 40% |
| Deductible Type | Embedded | |
| PCP Office Visit Copay | Deductible; 20% | Deductible; 40% |
| Specialist Office Visit Copay | Deductible; 20% | Deductible; 40% |
| Preventive Visits | Covered 100% | Deductible; 40% |
| Virtual Visit Copay – PCP | $80 | Not Covered |
| Emergency Room Copay | Deductible; 20% | |
| Urgent Care Services Copay | Deductible; 20% | Deductible; 40% |
| Prescription Drug | ||
| Deductible – Rx | Must meet medical deductible | |
| Prescription Drugs Retail | Deductible; 40% | |
| Prescription Drugs Mail Order | Deductible; 40% | |
*If you are enrolled in Family coverage, a member can meet the single deductible and benefits will be payable for that member. The family deductible does not need to be satisfied first.
To save money on office visits, use an In-Network Primary Care and Specialist doctors. To save money on labwork, use a lab in the Preferred Lab Network. Log onto anthem.com/find-care/ to search for Providers, Hospitals, or Other Care Providers. Or, call Anthem customer service for assistance at 1-833-952-2042.
