Under this HMO, you must use Anthem MyChoice providers; there is no out-of-network coverage (except in an emergency). You must choose an Anthem MyChoice doctor as your primary care physician (PCP) to be your first point of contact, coordinate your care, and make referrals. When you need care, you’re charged $30 per office visit ($40 for specialists, for which you must have a referral), and the plan pays the rest of the covered expense. Participants in Anthem MyChoice do not qualify for any of the healthy choices incentives; they are not charged the working spouse surcharge.
To find providers in the Anthem MyChoice HMO:
- Go to www.anthem.com/ca and click on “Basic search as a guest,” then follow the steps below.
- Under “Select the type of plan or network” select “Medical Plan or Network.”
- Under “Medical Plan or Network” select the name of your state.
- Under “Medical Plan or Network” select “Medical (Employer-Sponsored).”
- Under “Select a plan/network,” select “Blue Cross HMO (CACare) – Large Group,”then click on “Continue.”
- Enter what type of doctor, specialty, and location you are looking for to get your search results.
- For more information about a provider, such as skills and training, click on the provider’s name on the screen that appears with your search results.
Anthem MyChoice HMO Evidence of Coverage
2023 Anthem MyChoice Plan – Summary of Benefits and Coverage
Beginning Saturday, Jan. 15, 2022, members covered by private health insurance or a group health plan are now able to purchase over-the-counter (OTC) COVID-19 tests authorized by the U.S. Food and Drug Administration (FDA) at no cost without a prescription. The reimbursement of OTC COVID-19 tests will remain in effect until November 12, 2023.
Members can log in to anthem.com/ca, go to “Claims & Payment,” and choose “Submit a Claim” for tests purchased on or after Jan. 15. Please be sure to keep your receipt to submit a claim online.
- In addition to the member demographic information that is normally filed with member submitted claims, you will also be required to certify that the test was purchased for personal use.
- See the COVID OTC Testing FAQs for further details.
- For additional information, please visit the Anthem OTC page or refer to the Anthem OTC COVID-19 test flyer.