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Anthem.com

By going to anthem.com you have access to tools and
information to help you manage your medical benefits.
Please note that you will need the ID number from your
Anthem medical card to register. Once you register on the
website, you can:

  ? View benefit and claim information
  ? Find a physician
  ? Print a temporary ID card
  ? Request a replacement ID card
  ? View preferred drug lists and prescription history
  ? Order prescriptions and over the counter products

       through the home-delivery pharmacy
  ? Set up email reminders for prescription refills
  ? And much, much more

Prescription Drug Benefits

Anthem Blue Cross Blue Shield manages the prescription drug program for both medical plans. Your
cost is generally a copay that you pay at the time you fill your prescription, no deductible. The copay
varies, depending on your medical plan, the drug classification (tier) and if it is filled at an in-network
retail pharmacy for a 30-day supply or from the home-delivery pharmacy. The home-delivery pharmacy
allows you to order your ongoing medications in a 90-day supply for less than it costs for a 90-day
supply filled at a retail pharmacy. See the Medication Guide for a list of covered medications at
anthem.com/pharmacyinformation or call the number on your Anthem ID card.

                          Prescription Drug Benefits

                               Applies to Both Medical Plans
In-Network Retail Pharmacy (up to 30-day supply) and Home Delivery (90-day supply)

         Tier 1               Tier 2                    Tier 3                      Tier 4
        Generic   Preferred Brand Name   Non-preferred Brand Name            Specialty Drugs

Retail   Home     Retail   Home                            Retail   Home     Retail   Home
        Delivery          Delivery                                 Delivery          Delivery

$10 copay $25 copay $30 copay $75 copay  $50 copay $125 copay                20% up to $200 per
                                                                                  occurrence

How the Medical Plans Work                                         Finding Network Providers

Deciding which medical plan choice is best for you comes down      To find network providers, go to anthem.com.
to understanding the differences between the two options. You      Click on the menu and select "Find a Doctor”
have several key differences to consider as described below.       under "Care” and search by selecting:

Networks                                                            ? For the KeyCare PPO Plan, Employer-
Both options use Anthem Blue Cross Blue Shield networks. The
network members are the medical professionals and facilities that         Sponsored Medical Plan—Anthem
have agreed to charge a negotiated amount for their services.             KeyCare (PPO)
The medical providers who are not members of the network are
not restricted to a set price, so you pay more when using out-of-   ? For the HealthKeepers HMO Plan,
network providers. See the website and phone number in the
Finding Network Providers box to locate network providers.                Employer-Sponsored Medical Plan—
                                                                          Anthem HealthKeepers (HMO)

                                                                   You can also call Anthem at 855-333-5735.
                                                                   You can find out more about your benefits and
                                                                   treatment options by visiting the Anthem
                                                                   website or by calling Anthem.

                                         6 2016-2017 Benefits Guide
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