Anthem Total Health Connections - Family Advocate

Starting 1/1/25, All Anthem members will have access to Total Health Connections, a white-glove customer service team specifically trained on Marvell’s plans. Your personal Total Health Connections Family Advocate can help you manage your health information, discuss your claims, provide health plan information, and give you wellness tips. The Family Advocates will be able to answer most of your prescription drug questions as well. For more complicated questions, a CarelonRx representative will be added to the call to ensure you get the answers you need as soon as possible.

Anthem Total Health Connections is designed to give you a seamless and hassle-free experience so you can focus on your health and well-being. Connect with your Total Health Advocate by calling the number on the back of your Anthem ID card or by logging into the Anthem Sydney Health App.

Sydney Health App

Starting 1/1/25, Anthem Blue Cross members have access to the Sydney Health app, which you can download on your smartphone or access online. The app allows you to easily manage your health care and connect with your Total Health Connections Family Advocate. You can use the app to: 

• Find doctors, hospitals, and pharmacies in your network
• Review costs for services—and get help finding the lowest cost option
• View your benefits, claims, and medical ID card
• Manage your prescriptions
• Chat with a nurse 24/7 for health advice
• Schedule appointments and virtual visits
• Get personalized wellness tips and programs
• Track your health goals
• Find the name and telephone number of your Total Health Connections Family Advocate, as well as send direct messages

The Sydney Health app is your one-stop shop for all your medical needs.

Pricing of Medication

When you enroll in an Anthem medical plan, you are automatically enrolled in a four-tier prescription drug plan through Anthem CarelonRx that provides multiple options to save money.  

• Price your prescription: Log in to anthem.com/ca and find the cost of your medications using the "Price a Medication" tool located in the Prescription drop-down menu.
  • By following these steps, you will see the expected amount you pay for the drug for a 90-day and 30-day prescription at various local pharmacies based on your zip code, as well as the mail-order cost if you order directly from Anthem CarelonRX.
    
    
• Find your prescription tier: You can find the tier of your medication by using the Anthem Prescription Drug List. PLEASE NOTE: This list is Anthem's public prescription drug list. Marvell's coverage has limitations and exclusions. This means that some drugs on this list may not be covered, depending on your plan’s design. For example, your plan might not cover certain drugs for cosmetic uses or to treat conditions such as weight loss, infertility, or erectile dysfunction. To find out if your drug is covered, log into your member portal or use the Sydney app to Price a Medication and refer to your plan documents.
  
  To view this list as it pertains to Marvell, you will need to log in to your Anthem account at anthem.com/ca and search for the formulary list.
  • Once you access the link, you can scroll down and enter your prescription in the search box.
  • The page will refresh, and you will scroll down to find more information within the linked prescription provided.
  • Click on your specified prescription, and a new window will appear with the tier information. 
• If your doctor prescribes a brand-name medicine that's available as a generic, your pharmacy will give you the preferred generic option unless your provider indicates "Dispense as Written." 
• If you are not an Anthem member, you can use pricing medication tools found on the internet, such as GoodRx. You'll still need to refer to the coverage of the medication on Marvellbenefits.com to determine the true copay/tier of the medication.
• For assistance, call Anthem CarelonRx at 1-833-261-2462 or contact your Anthem Family Advocate through the Sydney app or at anthem.com/ca. 

Where to Get Your Medication 

• Short-term medications: Prescriptions for up to 30 days can be picked up at any in-network pharmacy.
• Long-term medications: Prescriptions you take regularly (over 30 days) must be filled through CarelonRx mail order or picked up at an Anthem retail pharmacy for a 90-day supply. See the Rx Maintenance 90 program details below. 

Rx Maintenance 90 (required for maintenance medication)

• Maintenance drugs you take regularly (over 30 days) for long-term conditions like asthma, heartburn, diabetes, etc., must be filled through mail order or picked up at an Anthem retail pharmacy for a 90-day supply. This is called the Rx Maintenance 90 program.
• The first 2-3 fills of your maintenance drugs for a 30-day supply and/or at a non-Anthem retail pharmacy will be covered; however, you will be asked to move your refill to a 90-day supply under this program. If you continue to refill your medication outside of the program, your cost will increase. 
• Whether you choose an Rx Maintenance 90 pharmacy or CarelonRx's home delivery, you'll pay the same, lower home delivery copay.
• Current eligible long-term medications for this program are listed on the Rx Maintenance 90 drug list. 
• For assistance moving your prescription to the Rx Maintenance 90 program, call Anthem CarelonRx at 1-833-261-2462 or your Anthem Family Advocate at 1-877-898-0739. 

Mail Order Home Delivery Program

Mail Order Prescriptions: Request a new script from your physician and submit a request for a new mail order prescription through Anthem's pharmacy benefits manager, CarelonRx, by either:

• Logging into your account at anthem.com/ca choose Pharmacy, and on your personal pharmacy page select View Your Prescriptions under Switch to a 90-day Supply. For the drugs you want to switch to home delivery, choose Switch to a 90-day Supply and then Select Prescriber; you can also add your shipping address, options, and payment methods on this page.
• Complete and send the Mail Service Order Form.

For assistance, call an Anthem Family Advocate at 1-833-261-2462. 

Anthem members have access to free* online doctor visits or psychologist visits 24/7 through LiveHealthOnline.com. Download the app and sign in (linking your Anthem member ID) so you're ready the next time you need medical attention:

Services include:

• Medical: Get advice, a treatment plan, and prescriptions (if needed)
• Kids: Speak immediately with a pediatrician and receive expert advice and treatment
• Psychology: Talk with a therapist from the privacy of your home in 4 days or less
• Psychiatry: See a psychiatrist and discuss possible medication management needs
• Allergy: Consult with a doctor who knows the latest allergy treatment trends

If you haven't enrolled in Anthem coverage yet and want to search for in-network doctors, please use the below instructions.

• Go to: anthem.com/ca/health-insurance/providerreimagine-directory/searchcriteria?brand=ABC 
• Click "Select a plan for basic search"
• When prompted, select the following:
  • Select the type of plan or network? Medical Plan
  • Select the state where the plan is offered? California
  • Select how you get health insurance? Medical (Employer-Sponsored)
  • Select a plan/network: National PPO (BlueCard PPO)
• The next page will prompt you to enter information to search for a specific provider or specialty. 
  • Type in your provider's information and your City, County, or Zip Code in the search bar and click Search to see results.
  • If you don't see your provider, call your provider's office and ask if they are in-network with Anthem Blue Cross.  

Before you leave, visit bcbsglobalcore.com to know your care options while abroad.

For more resources available to Marvell employees when traveling, visit the Travel page of this website.

Facing a medical decision? Marvell employees and their family members (including spouses, children, parents, grandparents, and siblings) have access to 2nd.MD. With 2nd.MD, you can connect with board-certified, expert doctors for an expert second opinion via phone or video — all within a matter of days, and at no cost to you.

Marvell's Exclusive, Preferred, and HDHP medical plans all offer coverage for gender affirming services including providing coverage for aesthetic gender-affirming services in order to better align with the WPATH standards of care. Marvell's Short-Term Disability programs will also provide coverage for aesthetic gender affirming services.

Learn more about how Marvell benefits support LGBTQIA communities.

• Prepare for your next preventive care visit
• 2023 Preventive health guidelines
• Protect yourself against breast cancer
• Alcohol and drug use: How to recognize there's a problem

Receive a free fitness tracker and wireless scale!

Roughly 88 million Americans are living with prediabetes, but 84% aren’t even aware they have it. Prediabetes often doesn’t cause symptoms, but it does increase the risk of developing type 2 diabetes, heart disease, and stroke. That’s why Anthem partnered with Lark to offer a diabetes prevention program that can help you determine if you’re at risk for prediabetes and, if needed, take steps to address it.

Lark's program can help you lose weight, eat healthier, increase activity, sleep better, and manage stress. For participating, you'll receive a free wireless scale, a personal activity tracker, and a digital coach available 24/7. 

To determine your risk level and whether you are eligible for Lark's program, visit lark.com/anthemBC. Learn more from this flyer and FAQ.

Members facing a cancer diagnosis will have access to a concierge service through Anthem to provide guidance on treatment and diagnosis, round-the-clock health monitoring, and VIP service at best-in-class clinical trials.

As a reminder, Marvell's standard Case Management Support for cancer is available for all members, which pairs members with an Anthem case manager certified in oncology to help members with cancer navigate the healthcare system and understand the benefits available to them. To be connected with a Case Manager, please contact Anthem.

Anthem members have free access to the Autism Spectrum Disorders (ASD) Program, which provides support for the entire family and helps you find and manage care. View this flyer for additional information or call the ASD Program Team at 1-844-269-0538.

Marvell also offers all employees free services to support families with developmental disabilities through Lyra.

Anthem members have access to two cycles of coverage; an infertility diagnosis is not required for Marvell Anthem members accessing reproductive assistance. Learn more about coverage levels.

Marvell supports our employees’ access to comprehensive healthcare. Should an employee or a covered dependent need access to abortion services that are not available in their community or state, Marvell’s Anthem Plans (Exclusive, Preferred, and High Deductible) will cover the medical service under the normal cost share (10% or 20% depending on the plan, after meeting the deductible) as well as reimburse for transportation and lodging up to $4,000/year with $150/night allowed for lodging. The travel benefit covers the Anthem member as well as a companion to an in-network facility that is more than 75 miles from their home. To file a claim for travel reimbursement, please return this claim form to Anthem. 

• Dental
• Hearing
• Eyewear
• LASIK
• Health and fitness
• Medicine and treatment
• Family 
• Pets

Anthem, like all medical carriers, has contracts with healthcare networks and providers to build a robust network across the U.S. Prior to the renewal date of the healthcare provider’s contract, Anthem and the provider discuss the contract terms, including reimbursement rates for different procedures, network access, quality standards, administrative processes, and other terms.

Typically, providers renew their contract with Anthem before the contract termination date, and there is no disruption to Anthem members. However, if Anthem and the provider cannot agree on contract terms by the contract termination date, the provider may go "out-of-network" with Anthem until both parties can reach an agreement.

Continuity of Care

When a provider goes out-of-network because the contract negotiations were not completed prior to the contract termination date, Anthem and the provider will share details on continuity of care for members who are in treatment or who had a scheduled treatment.

In general, after the contract termination, the provider would be considered out-of-network for new treatments, resulting in no coverage or higher out-of-pocket costs for Anthem members, depending on the member’s medical plan out-of-network coverage.

If the Anthem member was receiving services for one of the following conditions at the time of the contract termination date, then typically, Anthem would honor the claims incurred for the following conditions:

• Acute condition: A medical or behavioral health condition involving a sudden onset of symptoms due to an illness or injury or requiring prompt medical attention (but for a limited time). Completion of covered services shall be provided for the duration of the acute condition.
• Serious chronic condition: A medical or behavioral health condition due to a disease, illness, or other medical or behavioral health problem or disorder that is serious and continues without a full cure, worsens over time, or requires ongoing treatment to keep it in remission or from getting even worse. Completion of covered services shall be provided for a period of time necessary to complete a course of treatment and to arrange for a safe transfer to another provider, as determined by the health plan in consultation with the member and the terminated provider or non-participating provider and consistent with good professional practice. Completion of covered services will be considered for a limited period of time, not to exceed twelve (12) months from the contract termination date or twelve (12) months from the effective date of coverage for a newly covered enrollee.
• Pregnancy: Completion of covered services shall be provided for the duration of the pregnancy, regardless of trimester, and during the immediate postpartum period.
• Maternal mental health condition: A mental health condition that can impact a woman during pregnancy, peri or postpartum, or that arises during pregnancy, in the peri or postpartum period, up to one year after delivery. For an individual who presents written documentation of being diagnosed with a maternal mental health condition from their treating health care provider, completion of covered services for the maternal mental health condition will be considered for a limited period of time, not to exceed twelve (12) months from the diagnosis or from the end of the pregnancy, whichever occurs later.
• Terminal illness: An incurable or irreversible condition that has a high probability of causing death within one year or less. Completion of covered services shall be provided for the duration of the terminal illness, which may exceed twelve (12) months from the contract termination date or twelve (12) months from the effective date of coverage for a new enrollee.
• Care of a newborn child between birth and age 36 months: Completion of covered services will be considered for a limited period of time, not to exceed twelve (12) months from the contract termination date or twelve (12) months from the effective date of coverage for a newly covered enrollee.
• The Performance of a surgery or other procedure that is authorized by the plan or its delegated provider and is scheduled to occur within 180 days of the contract’s termination date or within 180 days of the effective date of coverage for a newly covered enrollee.

Network Status Updates

Please see the following information from Anthem and click on the microsite link, if available, for details. You may also contact Anthem at 877-898-0739 for a status update or to ask questions. To access participating provider information, visit www.anthem.com.