Anthem Blue Cross RightPlan 40

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A simple plan design with no medical deductible.

Looking for a California health insurance plan that’s easy to use but still has the benefits you need? Our RightPlan PPO 40 offers:

No medical deductible to worry about. Benefits are immediate – with a $40 copay for doctor visits.

Lower rates on services when you use our PPO network of more than 50,000 doctors and 400 hospitals.

Choice of three prescription drug coverage options. With no deductible on generic drugs.

Single policy coverage. This means that each family member gets his or her own policy.

Health and wellness programs. Learn how to improve your health with online access to health-related information, tools and product discounts.

Out-of-state coverage. This protects you from the high cost of unexpected emergencies when you travel.

For extra security, Anthem Blue Cross offers dental and life insurance plans that you can add to your medical coverage.

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Get Prices for the RightPlan PPO 40

Benefits-at-a-glance for RightPlan PPO 40


Plan Benefits		RightPlan PPO 40
		In-Network	Out-of-Network
Annual Deductible Choices	Individual	$0
	Family
Annual Out-of-Pocket Limit¹ (in addition to deductible, if any)	Individual	$7,500
	Family	Not applicable
Lifetime Maximum		Plan pays up to $5 Million per member

Covered Services The amounts shown are your share of costs after any deductible		In-Network	Out-of-Network
Doctors’ Office Visits		$40 copay	50% of negotiated fee plus all excess charges
Professional Services (x-ray, lab, anesthesia, surgeon, etc.)		40% of negotiated fee	50% of negotiated fee plus all excess charges
Hospital Inpatient (overnight hospital stays)		40% of negotiated fee²plus $500 copay per day for first four days, per admission	All charges except $650 per day
Hospital Outpatient (if you don’t stay overnight)		40% of negotiated fee²plus $500 copay per surgical admission	All charges except $380 per day
Emergency Room Services ($100 copay applies for each visit; waived if admitted as inpatient)		40% of negotiated fee	40% of customary and reasonable fees plus all excess charges
Maternity		not covered
Preventive Care (tests ordered by physician are covered, including appropriate screening for breast, cervical, ovarian, and prostate cancer)	Adult Services	HealthyCheck Centers: $25/$75 copay for basic/premium screening Routine mammogram, Pap and PSA tests: $40 office visit plus 40% of negotiated fee	50% of negotiated fee plus all excess charges
	Children’s Services	Well-Child (through age 6) $40 office visit plus 40% of negotiated fee
Acupuncture / Acupressure		All charges except $25 per visit, up to 24 visits per year
Chiropractic Services		40% of negotiated fee	All charges except $25 per visit
		Plan covers up to 12 visits per year

Prescription Drug Coverage Options		In-Network	Out-of-Network
Comprehensive Prescription Drug Coverage		Generic: $10 copay Brand-name: $30 copay after $500 brand-name deductible	50% of drug limited fee schedule and all excess charges plus the copay/coinsurance as stated for in-network benefits; subject to the $500 annual brand-name prescription drug deductible
Generic Prescription Drug Coverage		$10 copay	50% of drug limited fee schedule and all excess charges plus the copay/coinsurance as stated for in-network benefits.
No Prescription Drug Coverage		This option is available with RightPlan PPO 40

1. Excludes non-participating charges in excess of the Anthem Blue Cross negotiated fee and non-participating charges in excess of customary and reasonable fees for emergency care. Copays/coinsurance to participating and non-participating providers apply to annual calendar year out-of-pocket limit except where specifically noted in the policy.
2. Additional $500 admission charge at participating hospitals (no additional charge for preferred participating) is for inpatient stays or outpatient surgery or infusion therapy. The charge is not required for ambulatory surgical centers or medical emergencies.

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Anthem Blue Cross RightPlan 40

RightPlan PPO 40