2020 Anthem Health Plan Rates

 

Public AgenciesRegion 1 Northern CA        Region 2 Central CA      Region 3 LA/ Riverside/ San BernardinoOut of StateSupplemental Plan to Medicare
Employee Only$   774.00$   749.00$   699.00$   899.00    $   513.00
Employee and One Dependent$1,699.00$1,499.00$1,399.00$1,850.00    $1,022.00
Employee and Two or more Dependents$2,199.00$1,960.00$1,894.00$2,223.00    $1,635.00

 

StateCalifornia             Out of StateSupplemental Plan to Medicare
Employee Only$  724.00$  899.00$  513.00
Employee and One Dependent$1449.00$1850.00$1022.00
Employee and Two or more Dependents$1,927.00$2,223.00$1,635.00

Maximum Out-of-Pocket Expense $2,000 per person/ $4,000 for a family.

Prescription Drugs

Retail
Generic$10.00 copay
Brand Formulary$25.00 copay
Brand Non-Formulary$45.00 copay
Mail Order
Generic$20.00 copay
Brand Formulary$40.00 copay
Brand Non-Formulary$75.00 copay

Body Scans are subject to a maximum $1,000 coverage limit every 36 months.