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ClearProtection Plus How It Works. Two Separate Deductibles. Each plan has two deductibles: Inpatient/outpatient surgical/ER services deductible Outpatient professional services deductible. Two Separate Deductibles.

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two separate deductibles
Two Separate Deductibles
  • Each plan has two deductibles:
    • Inpatient/outpatient surgical/ER services deductible
    • Outpatient professional services deductible
two separate deductibles3
Two Separate Deductibles
  • 40% coinsurance applies for inpatient, outpatient surgical, and emergency room services after the Inpatient/Outpatient Surgical/ER Deductible is met
    • Member pays 100% of the negotiated rate before the deductible is met
two separate deductibles4
Two Separate Deductibles
  • 0% coinsurance applies to outpatient professional services after the Outpatient Professional services Deductible is met
    • Member pays 100% of the negotiated rate before the deductible is met
two separate deductibles5
Two Separate Deductibles
  • The Outpatient Professional Services Deductible amount is equal to the Total OOP Maximum amount

All in-network covered services covered at 100% (0% coinsurance) after the Total OOP Maximum is met.

clearprotection plus scenario 1
ClearProtection Plus Scenario 1

$1000 Deductible ClearProtection Plus Plan: Member gets $5000 Inpatient Procedure

clearprotection plus scenario 17
ClearProtection Plus Scenario 1

$1000 Deductible ClearProtection Plus Plan: Member gets $5000 Inpatient Procedure; member then gets $1000 outpatient surgical procedure

clearprotection plus scenario 18
ClearProtection Plus Scenario 1

$1000 Deductible ClearProtection Plus Plan: Member gets $5000 Inpatient Procedure; member then gets $1000 outpatient surgical procedure; member needs $2000 in professional services

clearprotection plus scenario 2
ClearProtection Plus Scenario 2

$1000 Deductible ClearProtection Plus Plan: Member gets $5000 in professional services

clearprotection plus scenario 210
ClearProtection Plus Scenario 2

$1000 Deductible ClearProtection Plus Plan: Member gets $5000 in professional services; member needs $5000 inpatient procedure

clearprotection plus scenario 3
ClearProtection Plus Scenario 3

$3300 Deductible ClearProtection Plus Plan: Member gets $2000 outpatient surgical procedure

clearprotection plus scenario 312
ClearProtection Plus Scenario 3

$3300 Deductible ClearProtection Plus Plan: Member gets $2000 outpatient surgical procedure; member spends $4,800 in outpatient/diagnostic services

Neither IP/Surgical or OP Professional Services Deductible met, however all subsequent services will be covered at 100% because the Total OOP Max is met

in a nutshell
In a nutshell…
  • Anthem shares cost of inpatient/surgical/ER procedures after inpatient/Surgical/ER deductible
  • $1000/$3300 – Individual
  • $2000/$6800 – Family
  • Anthem shares cost of outpatient/professional services after outpatient/professional deductible
  • $4500/$6800 – Individual
  • $9000/$13600 – Family
  • Anthem will pay 100% of all in-network covered services, including outpatient professional services, after the total OOP Maximum is met
  • $4500/$6800 – Individual
  • $9000/$13600 – Family
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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 is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross names and symbols are registered marks of the Blue Cross Association.
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