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Anthem Senior Health Insurance in OHIO – Health Plan Options

Anthem Senior — Patriot Class 1

A comparison of the Patriot Class 1 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	see brochure	see brochure
Deductible	see brochure	see brochure

Anthem Senior — Patriot Class 3

A comparison of the Patriot Class 3 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	see brochure
Copay	see brochure	see brochure
Deductible	see brochure	see brochure

Anthem Senior — Patriot Class 4

A comparison of the Patriot Class 4 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	N/A	N/A
Office Visit	Doctor visit: $60/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)	Doctor visit: $60/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)
Copay	Doctor visit: $60/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)	Doctor visit: $60/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)
Deductible	N/A	N/A

Anthem Senior — Patriot Class 5

A comparison of the Patriot Class 5 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	N/A	N/A
Office Visit	Doctor visit: $70/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)	Doctor visit: $70/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)
Copay	Doctor visit: $70/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)	Doctor visit: $70/visit (Up to 5 visits on the individual plan and up to 8 vists per calendar year per family)
Deductible	N/A	N/A

Anthem Senior — Short Term Medical

A comparison of the Short Term Medical offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Anthem Senior — Short Term Medical

A comparison of the Short Term Medical offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Anthem Senior — Short Term Medical

A comparison of the Short Term Medical offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Anthem Senior — Short Term Medical

A comparison of the Short Term Medical offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Anthem Senior — Short Term Medical

A comparison of the Short Term Medical offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Anthem Senior — Short Term Medical

A comparison of the Short Term Medical offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Anthem Senior — Short Term Medical

A comparison of the Short Term Medical offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Anthem Senior — Short Term Medical

A comparison of the Short Term Medical offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Anthem Senior — Short Term Medical

A comparison of the Short Term Medical offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Anthem Senior — Short Term Medical

A comparison of the Short Term Medical offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Anthem Senior — Short Term Medical

A comparison of the Short Term Medical offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Anthem Senior — Short Term Medical

A comparison of the Short Term Medical offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Anthem Senior — Short Term Medical

A comparison of the Short Term Medical offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illness and injury, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$250	$250

Anthem Senior — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Anthem Senior — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Anthem Senior — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Anthem Senior — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Anthem Senior — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Anthem Senior — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Anthem Senior — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Anthem Senior — HealthSaver Limited-Benefit

A comparison of the HealthSaver Limited-Benefit offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.	Covered for unexpected illnesses and accidents, subject to deductible and coinsurance. 24/7 Teladoc services are included as well. See brochure for more details.
Copay	N/A	N/A
Deductible	$7,500	$7,500

Anthem Senior — MedOne Plus- PPO Benefit Plan

A comparison of the MedOne Plus- PPO Benefit Plan offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	Subject to deductible, then coinsurance
Copay	see brochure	see brochure
Deductible	$2,500(2 per family maximum)	$5,000(2 per family maximum)

Anthem Senior — MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50%

A comparison of the MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50% offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	Subject to deductible, then coinsurance.
Copay	see brochure	see brochure
Deductible	$2,500(2 per family maximum)	$5,000(2 per family maximum)

Anthem Senior — MedOne- HSAvings Individual

A comparison of the MedOne- HSAvings Individual offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Subject to deductible, then coinsurance.	Subject to deductible, then coinsurance.
Copay	N/A	N/A
Deductible	$2,800	$5,600

Anthem Senior — MedOne Plus- PPO Benefit Plan

A comparison of the MedOne Plus- PPO Benefit Plan offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	Subject to deductible, then coinsurance
Copay	see brochure	see brochure
Deductible	$2,500(2 per family maximum)	$5,000(2 per family maximum)

Anthem Senior — MedOne- HSAvings Individual with Wellness

A comparison of the MedOne- HSAvings Individual with Wellness offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	Plan pays 100%	Plan pays 70%
Office Visit	Subject to deductible, then coinsurance.	Subject to deductible, then coinsurance.
Copay	N/A	N/A
Deductible	$2,800	$5,600

Anthem Senior — MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50%

A comparison of the MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50% offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	Subject to deductible, then coinsurance.
Copay	see brochure	see brochure
Deductible	$2,500(2 per family maximum)	$5,000(2 per family maximum)

Anthem Senior — MedOne Security- PPO Facility Copay Plan

A comparison of the MedOne Security- PPO Facility Copay Plan offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	$30 Copay then 100%	Subject to deductible, then 70% coinsurance.
Copay	$30	N/A
Deductible	$1,000(2 per family maximum)	$2,000(2 per family maximum)

Anthem Senior — MedOne Security- PPO Facility Copay Plan w/Rx Opt $0/$15/50%

A comparison of the MedOne Security- PPO Facility Copay Plan w/Rx Opt $0/$15/50% offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	Subject to deductible, then coinsurance.
Copay	see brochure	see brochure
Deductible	$1,000(2 per family maximum)	$2,000(2 per family maximum)

Anthem Senior — MedOne Security- PPO Facility Copay Plan

A comparison of the MedOne Security- PPO Facility Copay Plan offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	$30 Copay then 100%	Subject to deductible, then 70% coinsurance.
Copay	$30	N/A
Deductible	$1,000(2 per family maximum)	$2,000(2 per family maximum)

Anthem Senior — MedOne Plus- PPO Benefit Plan

A comparison of the MedOne Plus- PPO Benefit Plan offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	Subject to deductible, then coinsurance
Copay	see brochure	see brochure
Deductible	$2,500(2 per family maximum)	$5,000(2 per family maximum)

Anthem Senior — MedOne Security- PPO Facility Copay Plan w/Rx Opt $0/$15/50%

A comparison of the MedOne Security- PPO Facility Copay Plan w/Rx Opt $0/$15/50% offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	Subject to deductible, then coinsurance.
Copay	see brochure	see brochure
Deductible	$1,000(2 per family maximum)	$2,000(2 per family maximum)

Anthem Senior — MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50%

A comparison of the MedOne Plus- PPO Benefit Plan w/Rx Opt $0/$15/50% offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	see brochure	Subject to deductible, then coinsurance.
Copay	see brochure	see brochure
Deductible	$2,500(2 per family maximum)	$5,000(2 per family maximum)

Anthem Senior — Copay Saver

A comparison of the Copay Saver offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)
Copay	see brochure	see brochure
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Saver

A comparison of the Copay Saver offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)
Copay	see brochure	see brochure
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Saver

A comparison of the Copay Saver offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)
Copay	see brochure	see brochure
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Saver

A comparison of the Copay Saver offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)
Copay	see brochure	see brochure
Deductible	$7,500 (maximum 2 per family, per calendar year)	$7,500 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Saver

A comparison of the Copay Saver offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible, 2 visits per person per calendar year, including wellness office visits (2 Additional Visits plan enhancement available)
Copay	see brochure	see brochure
Deductible	$10,000 (maximum 2 per family, per calendar year)	$10,000 (maximum 2 per family, per calendar year)

Anthem Senior — Single HSA 100

A comparison of the Single HSA 100 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	see brochure	see brochure
Deductible	$1,250 (one per family, per calendar year)	$1,250 (one per family, per calendar year)

Anthem Senior — Single HSA 100

A comparison of the Single HSA 100 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	see brochure	see brochure
Deductible	$2,500 (one per family, per calendar year)	$2,500 (one per family, per calendar year)

Anthem Senior — Single HSA 100

A comparison of the Single HSA 100 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	see brochure	see brochure
Deductible	$3,000 (one per family, per calendar year)	$3,000 (one per family, per calendar year)

Anthem Senior — Single HSA 100

A comparison of the Single HSA 100 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	see brochure	see brochure
Deductible	$3,500 (one per family, per calendar year)	$3,500 (one per family, per calendar year)

Anthem Senior — Single HSA 100

A comparison of the Single HSA 100 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	see brochure	see brochure
Deductible	$5,000 (one per family, per calendar year)	$5,000 (one per family, per calendar year)

Anthem Senior — Single HSA 70

A comparison of the Single HSA 70 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: You pay: 30% after deductible	Office Visit - History and Exam: You pay: 30% after deductible
Copay	see brochure	see brochure
Deductible	$1,250 (one per family, per calendar year)	$1,250 (one per family, per calendar year)

Anthem Senior — Single HSA 70

A comparison of the Single HSA 70 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: You pay: 30% after deductible	Office Visit - History and Exam: You pay: 30% after deductible
Copay	see brochure	see brochure
Deductible	$2,500 (one per family, per calendar year)	$2,500 (one per family, per calendar year)

Anthem Senior — Single HSA 70

A comparison of the Single HSA 70 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: You pay: 30% after deductible	Office Visit - History and Exam: You pay: 30% after deductible
Copay	see brochure	see brochure
Deductible	$3,000 (one per family, per calendar year)	$3,000 (one per family, per calendar year)

Anthem Senior — Single HSA 70

A comparison of the Single HSA 70 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: You pay: 30% after deductible	Office Visit - History and Exam: You pay: 30% after deductible
Copay	see brochure	see brochure
Deductible	$3,500 (one per family, per calendar year)	$3,500 (one per family, per calendar year)

Anthem Senior — Single HSA 70

A comparison of the Single HSA 70 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: You pay: 30% after deductible	Office Visit - History and Exam: You pay: 30% after deductible
Copay	see brochure	see brochure
Deductible	$5,000 (one per family, per calendar year)	$5,000 (one per family, per calendar year)

Anthem Senior — Plan 100

A comparison of the Plan 100 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	N/A	N/A
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Anthem Senior — Plan 100

A comparison of the Plan 100 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	N/A	N/A
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Anthem Senior — Plan 100

A comparison of the Plan 100 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	N/A	N/A
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Anthem Senior — Plan 100

A comparison of the Plan 100 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	N/A	N/A
Deductible	$7,500 (maximum 2 per family, per calendar year)	$7,500 (maximum 2 per family, per calendar year)

Anthem Senior — Plan 100

A comparison of the Plan 100 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: No charge after deductible	Office Visit - History and Exam: No charge after deductible
Copay	N/A	N/A
Deductible	$10,000 (maximum 2 per family, per calendar year)	$10,000 (maximum 2 per family, per calendar year)

Anthem Senior — Plan 80

A comparison of the Plan 80 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: You pay: 20% after deductible	Office Visit - History and Exam: You pay: 20% after deductible
Copay	N/A	N/A
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Anthem Senior — Plan 80

A comparison of the Plan 80 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: You pay: 20% after deductible	Office Visit - History and Exam: You pay: 20% after deductible
Copay	N/A	N/A
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Anthem Senior — Plan 80

A comparison of the Plan 80 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: You pay: 20% after deductible	Office Visit - History and Exam: You pay: 20% after deductible
Copay	N/A	N/A
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Anthem Senior — Plan 80

A comparison of the Plan 80 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: You pay: 20% after deductible	Office Visit - History and Exam: You pay: 20% after deductible
Copay	N/A	N/A
Deductible	$7,500 (maximum 2 per family, per calendar year)	$7,500 (maximum 2 per family, per calendar year)

Anthem Senior — Plan 80

A comparison of the Plan 80 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: You pay: 20% after deductible	Office Visit - History and Exam: You pay: 20% after deductible
Copay	N/A	N/A
Deductible	$10,000 (maximum 2 per family, per calendar year)	$10,000 (maximum 2 per family, per calendar year)

Anthem Senior — Saver 80

A comparison of the Saver 80 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: Not covered	Office Visit - History and Exam: Not covered
Copay	N/A	N/A
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Anthem Senior — Saver 80

A comparison of the Saver 80 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: Not covered	Office Visit - History and Exam: Not covered
Copay	N/A	N/A
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Anthem Senior — Saver 80

A comparison of the Saver 80 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: Not covered	Office Visit - History and Exam: Not covered
Copay	N/A	N/A
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Anthem Senior — Saver 80

A comparison of the Saver 80 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: Not covered	Office Visit - History and Exam: Not covered
Copay	N/A	N/A
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Anthem Senior — Saver 80

A comparison of the Saver 80 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: Not covered	Office Visit - History and Exam: Not covered
Copay	N/A	N/A
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Anthem Senior — Saver 80

A comparison of the Saver 80 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: Not covered	Office Visit - History and Exam: Not covered
Copay	N/A	N/A
Deductible	$7,500 (maximum 2 per family, per calendar year)	$7,500 (maximum 2 per family, per calendar year)

Anthem Senior — Saver 80

A comparison of the Saver 80 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: Not covered	Office Visit - History and Exam: Not covered
Copay	N/A	N/A
Deductible	$10,000 (maximum 2 per family, per calendar year)	$10,000 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$500 (maximum 2 per family, per calendar year)	$500 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$1,000 (maximum 2 per family, per calendar year)	$1,000 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$1,500 (maximum 2 per family, per calendar year)	$1,500 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$2,500 (maximum 2 per family, per calendar year)	$2,500 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$3,500 (maximum 2 per family, per calendar year)	$3,500 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$3,500 (maximum 2 per family, per calendar year)	$3,500 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$3,500 (maximum 2 per family, per calendar year)	$3,500 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$5,000 (maximum 2 per family, per calendar year)	$5,000 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$7,500 (maximum 2 per family, per calendar year)	$7,500 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$7,500 (maximum 2 per family, per calendar year)	$7,500 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$7,500 (maximum 2 per family, per calendar year)	$7,500 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	100%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$10,000 (maximum 2 per family, per calendar year)	$10,000 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	80%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$10,000 (maximum 2 per family, per calendar year)	$10,000 (maximum 2 per family, per calendar year)

Anthem Senior — Copay Select

A comparison of the Copay Select offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	70%
Office Visit	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)	Office Visit - History and Exam: $35 copay - no deductible ($25 Copay plan enhancement available)
Copay	see brochure	see brochure
Deductible	$10,000 (maximum 2 per family, per calendar year)	$10,000 (maximum 2 per family, per calendar year)

Anthem Senior — QHDHP 90% $1200 w/o HSA (includes Dental)

A comparison of the QHDHP 90% $1200 w/o HSA (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	90% after deductible	50% after deductible
Office Visit	90% after deductible	50% after deductible
Copay	N/A	N/A
Deductible	Individual: $1,200, Family: $2,400	Individual: $2,400, Family: $4,800

Anthem Senior — QHDHP 90% $2000 w/o HSA (includes Dental)

A comparison of the QHDHP 90% $2000 w/o HSA (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	90% after deductible	50% after deductible
Office Visit	90% after deductible	50% after deductible
Copay	N/A	N/A
Deductible	Individual: $2,000, Family: $4,000	Individual: $4,000, Family: $8,000

Anthem Senior — QHDHP 90% $3000 w/o HSA (includes Dental)

A comparison of the QHDHP 90% $3000 w/o HSA (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	90% after deductible	50% after deductible
Office Visit	90% after deductible	50% after deductible
Copay	N/A	N/A
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Anthem Senior — QHDHP 80% $1200 w/o HSA (includes Dental)

A comparison of the QHDHP 80% $1200 w/o HSA (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	50% after deductible
Office Visit	80% after deductible	50% after deductible
Copay	N/A	N/A
Deductible	Individual: $1,200, Family: $2,400	Individual: $2,400, Family: $4,800

Anthem Senior — QHDHP 80% $3000 w/o HSA (includes Dental)

A comparison of the QHDHP 80% $3000 w/o HSA (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	50% after deductible
Office Visit	80% after deductible	50% after deductible
Copay	N/A	N/A
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Anthem Senior — QHDHP 90% $1200 w HSA (includes Dental)

A comparison of the QHDHP 90% $1200 w HSA (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	90% after deductible	50% after deductible
Office Visit	90% after deductible	50% after deductible
Copay	N/A	N/A
Deductible	Individual: $1,200, Family: $2,400	Individual: $2,400, Family: $4,800

Anthem Senior — QHDHP 80% $1200 w HSA (includes Dental)

A comparison of the QHDHP 80% $1200 w HSA (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	50% after deductible
Office Visit	80% after deductible	50% after deductible
Copay	N/A	N/A
Deductible	Individual: $1,200, Family: $2,400	Individual: $2,400, Family: $4,800

Anthem Senior — QHDHP 90% $2000 w HSA (includes Dental)

A comparison of the QHDHP 90% $2000 w HSA (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	90% after deductible	50% after deductible
Office Visit	90% after deductible	50% after deductible
Copay	N/A	N/A
Deductible	Individual: $2,000, Family: $4,000	Individual: $4,000, Family: $8,000

Anthem Senior — QHDHP 90% $3000 w HSA (includes Dental)

A comparison of the QHDHP 90% $3000 w HSA (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	90% after deductible	50% after deductible
Office Visit	90% after deductible	50% after deductible
Copay	N/A	N/A
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Anthem Senior — QHDHP 80% $3000 w HSA (includes Dental)

A comparison of the QHDHP 80% $3000 w HSA (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	50% after deductible
Office Visit	80% after deductible	50% after deductible
Copay	N/A	N/A
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Anthem Senior — QHDHP 100% $1250 w/o HSA (includes Dental)

A comparison of the QHDHP 100% $1250 w/o HSA (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	50% after deductible
Office Visit	Primary Care Visit- $15 Copay after deductible, Specialist Visit- $25 Copay after deductible	50% after deductible
Copay	Primary Care Visit- $15 Copay after deductible, Specialist Visit- $25 Copay after deductible	50% after deductible
Deductible	Individual: $1,250, Family: $2,500	Individual: $2,500, Family: $5,000

Anthem Senior — QHDHP 100% $2500 w/o HSA (includes Dental)

A comparison of the QHDHP 100% $2500 w/o HSA (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	50% after deductible
Office Visit	100% after deductible	50% after deductible
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Anthem Senior — QHDHP 100% $3750 w/o HSA (includes Dental)

A comparison of the QHDHP 100% $3750 w/o HSA (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	50% after deductible
Office Visit	Primary Care Visit- $15 Copay after deductible, Specialist Visit- $25 Copay after deductible	50% after deductible
Copay	Primary Care Visit- $15 Copay after deductible, Specialist Visit- $25 Copay after deductible	50% after deductible
Deductible	Individual: $3,750, Family: $7,500	Individual: $7,500, Family: $15,000

Anthem Senior — QHDHP 100% $1250 w HSA (includes Dental)

A comparison of the QHDHP 100% $1250 w HSA (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	50% after deductible
Office Visit	100% after deductible	50% after deductible
Copay	Primary Care Visit- $15 Copay after deductible, Specialist Visit- $25 Copay after deductible	50% after deductible
Deductible	Individual: $1,250, Family: $2,500	Individual: $2,500, Family: $5,000

Anthem Senior — QHDHP 100% $2500 w HSA (includes Dental)

A comparison of the QHDHP 100% $2500 w HSA (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	50% after deductible
Office Visit	100% after deductible	50% after deductible
Copay	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Anthem Senior — QHDHP 100% $3750 w HSA (includes Dental)

A comparison of the QHDHP 100% $3750 w HSA (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	Primary Care Visit- $15 Copay after deductible, Specialist Visit- $25 Copay after deductible	50% after deductible
Copay	Primary Care Visit- $15 Copay after deductible, Specialist Visit- $25 Copay after deductible	50% after deductible
Deductible	Individual: $3,750, Family: $7,500	Individual: $7,500, Family: $15,000

Anthem Senior — Copay 100% $0 $25/$50 PCP/SP (includes Dental)

A comparison of the Copay 100% $0 $25/$50 PCP/SP (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	50% after deductible
Office Visit	Primary Care Visit- $25 Copay, Specialist- $50 Copay	50% after deductible
Copay	Primary Care Visit- $25 Copay, Specialist- $50 Copay	50% after deductible
Deductible	None	Individual: $5,000, Family: $10,000

Anthem Senior — Deductible 80% $500 (includes Dental)

A comparison of the Deductible 80% $500 (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	50% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	Individual: $500, Family: $1,000	Individual: $1,000, Family: $2,000

Anthem Senior — Deductible 80% $750 (includes Dental)

A comparison of the Deductible 80% $750 (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible	50% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	Individual: $750, Family: $1,500	Individual: $1,500, Family: $3,000

Anthem Senior — Deductible 100% $5000 (includes Dental)

A comparison of the Deductible 100% $5000 (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	50% after deductible
Office Visit	Subject to deductible and coinsurance	Subject to deductible and coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Anthem Senior — Copay 100% $0 (includes Dental)

A comparison of the Copay 100% $0 (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	50% after deductible
Office Visit	Primary Care Visit- $20 Copay, Specialist Visit- $40 Copay	50% after deductible
Copay	Primary Care Visit- $20 Copay, Specialist Visit- $40 Copay	50% after deductible
Deductible	None	$5,000 Individual, $10,000 Family

Anthem Senior — Copay 90% $1000 / $2K OOPM (includes Dental)

A comparison of the Copay 90% $1000 / $2K OOPM (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	90% after deductible	50% after deductible
Office Visit	Primary Care Visit- $20 Copay, Specialist Visit- $40 Copay	50% after deductible
Copay	Primary Care Visit- $20 Copay, Specialist Visit- $40 Copay	50% after deductible
Deductible	$1,000 Individual, $2,000 Family	$2,000 Individual, $4,000 Family

Anthem Senior — Copay 90% $1000 / $3K OOPM (includes Dental)

A comparison of the Copay 90% $1000 / $3K OOPM (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	90% after deductible	50% after deductible
Office Visit	Primary Care Visit- $20 Copay, Specialist Visit- $40 Copay	50% after deductible
Copay	Primary Care Visit- $20 Copay, Specialist Visit- $40 Copay	50% after deductible
Deductible	$1,000 Individual, $2,000 Family	$2,000 Individual, $4,000 Family

Anthem Senior — Copay 100% $1200 (includes Dental)

A comparison of the Copay 100% $1200 (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible	50% after deductible
Office Visit	Primary Care Visit- $20 Copay, Specialist Visit- $40 Copay	50% after deductible
Copay	Primary Care Visit- $20 Copay, Specialist Visit- $40 Copay	50% after deductible
Deductible	$1,200 Individual, $2,400 Family	$2,400 Individual, $4,800 Family

Anthem Senior — Copay 90% $2000 (includes Dental)

A comparison of the Copay 90% $2000 (includes Dental) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	90% after deductible	50% after deductible
Office Visit	Primary Care Visit- $20 Copay, Specialist Visit- $40 Copay	50% after deductible
Copay	Primary Care Visit- $20 Copay, Specialist Visit- $40 Copay	50% after deductible
Deductible	Individual: $2,000, Family: $4,000	Individual: $4,000, Family: $8,000

Anthem Senior — First Dollar PPO 30

A comparison of the First Dollar PPO 30 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% up to out of pocket max. $0 once out of pocket max is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max is satisfied.
Office Visit	Non-Specialist Office Visit: $30 copay (unlimited visits), Specialist Visit: $40 copay (unlimited visits)	Non-Specialist Office Visit: 50% after deductible (unlimited visits), Specialist Visit: 50% after deductible (unlimited visits).
Copay	Non-Specialist Office Visit: $30 copay (unlimited visits), Specialist Visit: $40 copay (unlimited visits)	Non-Specialist Office Visit: 50% after deductible (unlimited visits), Specialist Visit: 50% after deductible (unlimited visits).
Deductible	Individual: $0, Family: $0	Individual: $5,000, Family: $10,000

Anthem Senior — First Dollar PPO 40

A comparison of the First Dollar PPO 40 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Office Visit: $40 Copay (unlimited visits), Specialist Visit: $50 Copay (unlimited visits)	Non-Specialist Office Visit: 50% after deductible (unlimited visits), Specialist Visit: 50% after deductible (unlimited visits)
Copay	Non-Specialist Office Visit: $40 Copay (unlimited visits), Specialist Visit: $50 Copay (unlimited visits)	Non-Specialist Office Visit: 50% after deductible (unlimited visits), Specialist Visit: 50% after deductible (unlimited visits)
Deductible	Individual: $0, Family: $0	Individual: $7,000, Family: $14,000

Anthem Senior — PPO 1500

A comparison of the PPO 1500 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $25 copay, deductible waived (Unlimited visits); Specialist Visit: $35 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $25 copay, deductible waived (Unlimited visits); Specialist Visit: $35 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

Anthem Senior — PPO 2500

A comparison of the PPO 2500 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay, deductible waived (Unlimited visits); Specialist Visit: $40 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay, deductible waived (Unlimited visits); Specialist Visit: $40 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Anthem Senior — PPO 5000

A comparison of the PPO 5000 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Office Visit: $40 copay deductible waived (unlimited visits), Specialist Visit: $50 copay deductible waived (unlimited visits).	50% after deductible (unlimited visits)
Copay	Non-Specialist Office Visit: $40 copay deductible waived (unlimited visits), Specialist Visit: $50 copay deductible waived (unlimited visits).	50% after deductible (unlimited visits)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Anthem Senior — PPO Value 5000

A comparison of the PPO Value 5000 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	65% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-5 $50 copay, deductible waived; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits); Specialist Visit: Visits 1-5 $50 copay, deductible waived; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits, Specialist and Non-Specialist will share visit max.)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-5 $50 copay plus 80% coinsurance, deductible applies; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits); Specialist Visit: Visits 1-5 $50 copay plus 80% coinsurance, deductible applies; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits, Specialist and Non-Specialist will share visit max.)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-5 $50 copay, deductible waived; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits); Specialist Visit: Visits 1-5 $50 copay, deductible waived; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits, Specialist and Non-Specialist will share visit max.)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-5 $50 copay plus 80% coinsurance, deductible applies; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits); Specialist Visit: Visits 1-5 $50 copay plus 80% coinsurance, deductible applies; Visit 5+ member is responsible for 100% but Aetna discount applies; Aetna will pay 100% after out-of-pocket maximum is satisfied (Unlimited visits, Specialist and Non-Specialist will share visit max.)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Anthem Senior — PPO High Deductible 3000 (HSA Compatible)

A comparison of the PPO High Deductible 3000 (HSA Compatible) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 100% after deductible (Unlimited visits); Specialist Visit: 100% after deductible (Includes Chiropractic Care Visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 100% after deductible (Unlimited visits); Specialist Visit: 100% after deductible (Includes Chiropractic Care Visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Anthem Senior — PPO High Deductible 5000 (HSA Compatible)

A comparison of the PPO High Deductible 5000 (HSA Compatible) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 100% after deductible (Unlimited visits); Specialist Visit: 100% after deductible (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 100% after deductible (Unlimited visits); Specialist Visit: 100% after deductible (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Anthem Senior — Preventive and Hospital Care 1250

A comparison of the Preventive and Hospital Care 1250 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered
Deductible	Individual: $1,250, Family: $2,500	Individual: $2,500, Family: $5,000

Anthem Senior — Preventive and Hospital Care 3000 (HSA Compatible)

A comparison of the Preventive and Hospital Care 3000 (HSA Compatible) offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Not covered	Not covered
Copay	Not covered	Not covered
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Anthem Senior — PPO Value 2500

A comparison of the PPO Value 2500 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out-of-pocket max. $0 once out-of-pocket max. is satisfied	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Office Visits 1-5 $30 copay, deductible waived; Specialist Visits 1-5 $50 copay, deductible waived.	Non-Specialist and Specialist Office Visit: 50% after deductible (unlimited visits).
Copay	Non-Specialist Office Visits 1-5 $30 copay, deductible waived; Specialist Visits 1-5 $50 copay, deductible waived.	Non-Specialist and Specialist Office Visit: 50% after deductible (unlimited visits).
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Anthem Senior — PPO Value 10000

A comparison of the PPO Value 10000 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist and Specialist Office Visit: Visits 1-2 $30 copay, deductible waived; Visits 3+ 70% after deductible. Specialist and Non-Specialist share visit max (unlimited visits).	Non-Specialist and Specialist Office Visit: 50% after deductible (unlimited visits).
Copay	Non-Specialist and Specialist Office Visit: Visits 1-2 $30 copay, deductible waived; Visits 3+ 70% after deductible. Specialist and Non-Specialist share visit max (unlimited visits).	Non-Specialist and Specialist Office Visit: 50% after deductible (unlimited visits).
Deductible	Individual: $10,000, Family: $20,000	Individual: $10,000, Family: $20,000

Anthem Senior — PPO 1500 with Medical $50K CYM

A comparison of the PPO 1500 with Medical $50K CYM offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible. $0 once out of pocket max. is satisfied	50% after deductible. $0 once out of pocket max. is satisfied
Office Visit	Non-Specialist Office Visit: $25 Copay (Unlimited visits), Specialist Visit: $50 Copay (Unlimited visits)	Non-Specialist Office Visit: 50% after deductible (Unlimited visits), Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit: $25 Copay (Unlimited visits), Specialist Visit: $50 Copay (Unlimited visits)	Non-Specialist Office Visit: 50% after deductible (Unlimited visits), Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

Anthem Senior — PPO 2500 with Medical $50K CYM

A comparison of the PPO 2500 with Medical $50K CYM offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible ($0 once out-of-pocket max. is satisfied)	50% after deductible ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $25 copay (Unlimited visits); Specialist Visit: $50 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $25 copay (Unlimited visits); Specialist Visit: $50 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Anthem Senior — First Dollar PPO 30 with Dental

A comparison of the First Dollar PPO 30 with Dental offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay (Unlimited visits); Specialist Visit: $40 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay (Unlimited visits); Specialist Visit: $40 copay (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $0, Family: $0	Individual: $5,000, Family: $10,000

Anthem Senior — First Dollar PPO 40 with Dental

A comparison of the First Dollar PPO 40 with Dental offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist Office Visit: $40 Copay (unlimited visits), Specialist Visit: $50 Copay (unlimited visits)	Non-Specialist Office Visit: 50% after deductible (unlimited visits), Specialist Visit: 50% after deductible (unlimited visits)
Copay	Non-Specialist Office Visit: $40 Copay (unlimited visits), Specialist Visit: $50 Copay (unlimited visits)	Non-Specialist Office Visit: 50% after deductible (unlimited visits), Specialist Visit: 50% after deductible (unlimited visits)
Deductible	Individual: $0, Family: $0	Individual: $7,000, Family: $14,000

Anthem Senior — PPO 1500 with Dental

A comparison of the PPO 1500 with Dental offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out of pocket max. $0 once out of pocket max is satisfied.50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or internist): $25 copay; Specialist Visit: $35 copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or internist): 50% after deductible; Specialist Visit: 50% after deductible
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or internist): $25 copay; Specialist Visit: $35 copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or internist): 50% after deductible; Specialist Visit: 50% after deductible
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

Anthem Senior — PPO 2500 with Dental

A comparison of the PPO 2500 with Dental offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay, deductible waived (Unlimited visits); Specialist Visit: $40 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $30 copay, deductible waived (Unlimited visits); Specialist Visit: $40 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Anthem Senior — PPO 5000 with Dental

A comparison of the PPO 5000 with Dental offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $40 copay, deductible waived (Unlimited visits); Specialist Visit: $50 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $40 copay, deductible waived (Unlimited visits); Specialist Visit: $50 copay, deductible waived (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Anthem Senior — PPO Value 5000 with Dental

A comparison of the PPO Value 5000 with Dental offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist and Specialist Office Visit: Visits 1-2 $30 copay, deductible waived; Visits 3+ 70% after deductible. Specialist and Non-Specialist share visit max (unlimited visits).	Non-Specialist and Specialist Office Visit: 50% after deductible (unlimited visits).
Copay	Non-Specialist and Specialist Office Visit: Visits 1-2 $30 copay, deductible waived; Visits 3+ 70% after deductible. Specialist and Non-Specialist share visit max (unlimited visits).	Non-Specialist and Specialist Office Visit: 50% after deductible (unlimited visits).
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Anthem Senior — PPO High Deductible 3000 (HSA Compatible) with Dental

A comparison of the PPO High Deductible 3000 (HSA Compatible) with Dental offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	70% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $0 copay after deductible (Unlimited visits); Specialist Visit: $0 copay after deductible (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $0 copay after deductible (Unlimited visits); Specialist Visit: $0 copay after deductible (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 70% after deductible (Unlimited visits); Specialist Visit: 70% after deductible (Unlimited visits)
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Anthem Senior — PPO High Deductible 5000 (HSA Compatible) with Dental

A comparison of the PPO High Deductible 5000 (HSA Compatible) with Dental offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 100% after deductible (Unlimited visits); Specialist Visit: 100% after deductible (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 100% after deductible (Unlimited visits); Specialist Visit: 100% after deductible (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Anthem Senior — Preventive and Hospital Care 1250 with Dental

A comparison of the Preventive and Hospital Care 1250 with Dental offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Not covered	Not covered
Copay	Not covered	Not covered
Deductible	Individual: $1,250, Family: $2,500	Individual: $2,500, Family: $5,000

Anthem Senior — Preventive and Hospital Care 3000 (HSA Compatible) with Dental

A comparison of the Preventive and Hospital Care 3000 (HSA Compatible) with Dental offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible up to out-of-pocket max.	50% after deductible up to out-of-pocket max.
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Not covered; Specialist Visit: Not covered
Deductible	Individual: $3,000, Family: $6,000	Individual: $6,000, Family: $12,000

Anthem Senior — PPO Value 2500 with Dental

A comparison of the PPO Value 2500 with Dental offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)	50% after deductible up to out-of-pocket max. ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-2 $30 copay, deducible waived; Visit 3+ 70% after deductible. Spec. and non-spec share visit max (Unlimited visits); Specialist Visit: Visits 1-2 $30 copay, deducible waived; Visit 3+ 70% after deductible. Spec. and non-spec share visit max (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist: 50% after deductible (Unlimited visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): Visits 1-2 $30 copay, deducible waived; Visit 3+ 70% after deductible. Spec. and non-spec share visit max (Unlimited visits); Specialist Visit: Visits 1-2 $30 copay, deducible waived; Visit 3+ 70% after deductible. Spec. and non-spec share visit max (Unlimited visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited visits); Specialist: 50% after deductible (Unlimited visits)
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Anthem Senior — PPO Value 10000 with Dental

A comparison of the PPO Value 10000 with Dental offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.	50% after deductible up to out of pocket max. $0 once out of pocket max. is satisfied.
Office Visit	Non-Specialist and Specialist Office Visit: Visits 1-2 $30 copay, deductible waived; Visits 3+ 70% after deductible. Specialist and Non-Specialist share visit max (unlimited visits).	Non-Specialist and Specialist Office Visit: 50% after deductible (unlimited visits).
Copay	Non-Specialist and Specialist Office Visit: Visits 1-2 $30 copay, deductible waived; Visits 3+ 70% after deductible. Specialist and Non-Specialist share visit max (unlimited visits).	Non-Specialist and Specialist Office Visit: 50% after deductible (unlimited visits).
Deductible	Individual: $10,000, Family: $20,000	Individual: $10,000, Family: $20,000

Anthem Senior — PPO 1500 with Medical $50K CYM with Dental

A comparison of the PPO 1500 with Medical $50K CYM with Dental offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible ($0 once out-of-pocket max. is satisfied)	50% after deductible ($0 once out-of-pocket max. is satisfied)
Office Visit	Non-Specialist Office Visit: $25 Copay (Unlimited visits), Specialist Visit: $50 Copay (Unlimited visits) Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $25 copay (Unlimited Visits); Specialist Visit: $50 copay (Unlimited Visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited Visits); Specialist Visit: 50% after deductible (Unlimited Visits)
Copay	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): $25 copay (Unlimited Visits); Specialist Visit: $50 copay (Unlimited Visits)	Non-Specialist Office Visit (General Physician, Family Practitioner, Pediatrician or Internist): 50% after deductible (Unlimited Visits); Specialist Visit: 50% after deductible (Unlimited Visits)
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

Anthem Senior — PPO 2500 with Medical $50K CYM with Dental

A comparison of the PPO 2500 with Medical $50K CYM with Dental offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible $0 once out-of-pocket max is satisfied.	50% after deductible $0 once out-of-pocket max is satisfied.
Office Visit	Non-Specialist Office Visit: $25 copay (Unlimited visits), Specialist Office Visit: $50 copay (Unlimited visits)	Non-Specialist Office Visit: 50% after deductible (unlimited visits), Specialist: 50% after deductible (unlimited visits)
Copay	Non-Specialist Office Visit: $25 copay (Unlimited visits), Specialist Office Visit: $50 copay (Unlimited visits)	Non-Specialist Office Visit: 50% after deductible (Unlimited visits), Specialist Office Visit: 50% after deductible (Unlimited visits)
Deductible	Individual: $2,500, Family: $5,000	Individual: $5,000, Family: $10,000

Anthem Senior — PPO 7500 with Unlimited Primary Care Visits plus Dental

A comparison of the PPO 7500 with Unlimited Primary Care Visits plus Dental offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80% after deductible, up to out-of-pocket max. $0 once out-of-pocket max. is satisfied.	50% after deductible, up to out-of-pocket max. $0 once out-of-pocket max. is satisfied.
Office Visit	Non-Specialist Office Visit: $30 copay deductible waived (unlimited visits), Specialist Visit: 80% after deductible (unlimited visits).	Non-Specialist Office Visit: 50% after deductible (unlimited visits), Specialist Visit: 50% after deductible (unlimited visits).
Copay	Non-Specialist Office Visit: $30 copay deductible waived (unlimited visits), Specialist Visit: 80% after deductible (unlimited visits).	Non-Specialist Office Visit: 50% after deductible (unlimited visits), Specialist Visit: 50% after deductible (unlimited visits).
Deductible	Individual: $7,500, Family: $15,000	Individual: $10,000, Family: $20,000

Anthem Senior — Generations HSA

A comparison of the Generations HSA offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $1,500	Individual:$2,000, Family: $4,000 $1,500

Anthem Senior — Generations HSA

A comparison of the Generations HSA offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $1,500	Individual:$2,000, Family: $4,000 $1,500

Anthem Senior — Generations HSA

A comparison of the Generations HSA offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,000	Individual:$2,000, Family: $4,000 $2,000

Anthem Senior — Generations HSA

A comparison of the Generations HSA offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,000	Individual:$2,000, Family: $4,000 $2,000

Anthem Senior — Generations HSA

A comparison of the Generations HSA offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,500	Individual:$2,000, Family: $4,000 $2,500

Anthem Senior — Generations HSA

A comparison of the Generations HSA offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,500	Individual:$2,000, Family: $4,000 $2,500

Anthem Senior — Generations HSA

A comparison of the Generations HSA offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $5,000	Individual:$2,000, Family: $4,000 $5,000

Anthem Senior — Generations HSA

A comparison of the Generations HSA offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $5,000	Individual:$2,000, Family: $4,000 $5,000

Anthem Senior — Generations HSA

A comparison of the Generations HSA offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $1,500	Individual:$2,000, Family: $4,000 $1,500

Anthem Senior — Generations HSA

A comparison of the Generations HSA offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $1,500	Individual:$2,000, Family: $4,000 $1,500

Anthem Senior — Generations HSA

A comparison of the Generations HSA offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,000	Individual:$2,000, Family: $4,000 $2,000

Anthem Senior — Generations HSA

A comparison of the Generations HSA offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,000	Individual:$2,000, Family: $4,000 $2,000

Anthem Senior — Generations HSA

A comparison of the Generations HSA offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,500	Individual:$2,000, Family: $4,000 $2,500

Anthem Senior — Generations HSA

A comparison of the Generations HSA offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,500	Individual:$2,000, Family: $4,000 $2,500

Anthem Senior — Generations HSA

A comparison of the Generations HSA offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $1,500	Individual:$2,000, Family: $4,000 $1,500

Anthem Senior — Generations HSA

A comparison of the Generations HSA offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $1,500	Individual:$2,000, Family: $4,000 $1,500

Anthem Senior — Generations HSA

A comparison of the Generations HSA offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,000	Individual:$2,000, Family: $4,000 $2,000

Anthem Senior — Generations HSA

A comparison of the Generations HSA offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,000	Individual:$2,000, Family: $4,000 $2,000

Anthem Senior — Generations HSA

A comparison of the Generations HSA offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,500	Individual:$2,000, Family: $4,000 $2,500

Anthem Senior — Generations HSA

A comparison of the Generations HSA offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual:$2,000, Family: $4,000 $2,500	Individual:$2,000, Family: $4,000 $2,500

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $750

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $750

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $1,500

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $1,500

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $2,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $2,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $2,500

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $2,500

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $5,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $5,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $10,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $10,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $15,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $15,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $20,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $20,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $25,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $25,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $750

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $750

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $1,500

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $1,500

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $2,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $2,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $2,500

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $2,500

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $5,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $5,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $10,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $10,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $15,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $15,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $20,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $20,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $25,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $25,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $750

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $750

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $1,500

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $1,500

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $2,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $2,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $2,500

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $2,500

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $5,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $5,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $10,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $10,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $15,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $15,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $20,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $20,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $25,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $25,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $750

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $750

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $1,500

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $1,500

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $2,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $2,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $2,500

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $2,500

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $5,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $5,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $10,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $10,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $15,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $15,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $20,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $20,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $25,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $25,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $750

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $750	Individual: $5,000, Family: $15,000 $750

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $1,500

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $1,500	Individual: $5,000, Family: $15,000 $1,500

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $2,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,000	Individual: $5,000, Family: $15,000 $2,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $2,500

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $2,500	Individual: $5,000, Family: $15,000 $2,500

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $5,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $5,000	Individual: $5,000, Family: $15,000 $5,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $10,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $10,000	Individual: $5,000, Family: $15,000 $10,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $15,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $15,000	Individual: $5,000, Family: $15,000 $15,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $20,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $20,000	Individual: $5,000, Family: $15,000 $20,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $25,000

Anthem Senior — Generations One

A comparison of the Generations One offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	see brochure	see brochure
Office Visit	Deductible then coinsurance	Deductible then coinsurance
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $15,000 $25,000	Individual: $5,000, Family: $15,000 $25,000

Anthem Senior — SuperMed One HSA 5000

A comparison of the SuperMed One HSA 5000 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	100% after deductible	50% after deductible
Copay	N/A	N/A
Deductible	Individual $5,000, Family $10,000	Individual $10,000, Family $20,000

Anthem Senior — SuperMed One Wellness HSA 5000

A comparison of the SuperMed One Wellness HSA 5000 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	100% after deductible	50% after deductible
Copay	N/A	N/A
Deductible	Individual $5,000, Family $10,000	Individual $10,000, Family $20,000

Anthem Senior — Short Term 1500/3000

A comparison of the Short Term 1500/3000 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	50%
Office Visit	Office Visit (Illness/Injury)- $25 copay, then 100%; Urgent Care Office Visit- $25 copay, then 100%	Office Visit (Illness/Injury)- $25 copay, then 50%; Urgent Care Office Visit- $25 copay, then 50%
Copay	Office Visit (Illness/Injury)- $25 copay, then 100%; Urgent Care Office Visit- $25 copay, then 100%	Office Visit (Illness/Injury)- $25 copay, then 50%; Urgent Care Office Visit- $25 copay, then 50%
Deductible	Individual: $1,500, Family: $3,000	Individual: $3,000, Family: $6,000

Anthem Senior — Short Term 1000/2000

A comparison of the Short Term 1000/2000 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	50%
Office Visit	Office Visit (Illness/Injury)- $25 copay, then 100; Urgent Care Office Visit- $25 copay, then 100%	Office Visit (Illness/Injury)- $25 copay, then 50%; Urgent Care Office Visit- $25 copay, then 50%
Copay	Office Visit (Illness/Injury)- $25 copay, then 100%; Urgent Care Office Visit- $25 copay, then 100%.	Office Visit (Illness/Injury)- $25 copay, then 50%; Urgent Care Office Visit- $25 copay, then 50%.
Deductible	Individual: $1,000, Family: $2,000	Individual: $2,000, Family: $4,000

Anthem Senior — SuperMed One Standard 10000 w/o Office Copay

A comparison of the SuperMed One Standard 10000 w/o Office Copay offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	100% after deductible	50% after deductible
Copay	N/A	N/A
Deductible	Individual $10,000, Family $20,000	Individual $20,000, Family $40,000

Anthem Senior — SuperMed One HSA 3000

A comparison of the SuperMed One HSA 3000 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	100% after deductible	50% after deductible
Copay	N/A	N/A
Deductible	Individual $3,000, Family $6,000	Individual $6,000, Family $12,000

Anthem Senior — SuperMed One Wellness HSA 3000

A comparison of the SuperMed One Wellness HSA 3000 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	100% after deductible	50% after deductible
Copay	N/A	N/A
Deductible	Individual $3,000, Family $6,000	Individual $6,000, Family $12,000

Anthem Senior — SuperMed One HSA 2500

A comparison of the SuperMed One HSA 2500 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	100% after deductible	50% after deductible
Copay	N/A	N/A
Deductible	Individual $2,500, Family $5,000	Individual $5,000, Family $10,000

Anthem Senior — Short Term 500/1000

A comparison of the Short Term 500/1000 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	80%	50%
Office Visit	Office Visit (Illness/Injury)- $25 copay, then 100%; Urgent Care Office Visit- $25 copay, then 100%	Office Visit (Illness/Injury)- $25 copay, then 50%; Urgent Care Office Visit- $25 copay, then 50%
Copay	Office Visit (Illness/Injury)- $25 copay, then 100%; Urgent Care Office Visit- $25 copay, then 100%	Office Visit (Illness/Injury)- $25 copay, then 50%; Urgent Care Office Visit- $25 copay, then 50%
Deductible	Individual: $500, Family: $1,000	Individual: $1,000, Family: $2,000

Anthem Senior — SuperMed One Standard 5000 w/o Office Copay

A comparison of the SuperMed One Standard 5000 w/o Office Copay offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	100% after deductible	50% after deductible
Copay	N/A	N/A
Deductible	Individual $5,000, Family $10,000	Individual $10,000, Family $20,000

Anthem Senior — SuperMed One Standard 10000 w/o Office Copay with Rx

A comparison of the SuperMed One Standard 10000 w/o Office Copay with Rx offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	$25 Copay, then 100%	50% after deductible
Copay	N/A	N/A
Deductible	Individual: $10,000, Family: $20,000	Individual: $20,000, Family: $40,000

Anthem Senior — SuperMed One Wellness HSA 2500

A comparison of the SuperMed One Wellness HSA 2500 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	100% after deductible	50% after deductible
Copay	N/A	N/A
Deductible	Individual $2,500, Family $5,000	Individual $5,000, Family $10,000

Anthem Senior — SuperMed One Standard 5000 w/o Office Copay with Rx

A comparison of the SuperMed One Standard 5000 w/o Office Copay with Rx offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	100% after deductible	50% after deductible
Copay	N/A	N/A
Deductible	Individual: $5,000, Family: $10,000	Individual: $10,000, Family: $20,000

Anthem Senior — SuperMed One Value 1500

A comparison of the SuperMed One Value 1500 offered by Anthem Senior is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70%	50%
Office Visit	70% after deductible	50% after deductible