Although you can go to a doctor, hospital or pharmacy that is not in the network, you will pay less if you go to one that is in the network.
To see if your health care providers (physicians, hospitals, labs and pharmacies) are in Anthem’s network before you are a member, visit welcometoanthem.com/xpo.
When you use an out-of-network provider, the plan will pay coinsurance based on Anthem’s maximum allowed amount. You are responsible for any portion of the provider’s charge that exceeds this amount. For example, if you have met your deductible, the plan will pay 50% of the maximum allowed amount for out-of-network care.
If your out-of-network provider charges $600 for a procedure and Anthem’s maximum allowed amount for the procedure is $500, you would pay 50% of the maximum allowed amount (50% x $500 = $250) plus the $100 that exceeds the maximum allowed amount, for a total of $350.
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