Help for Anthem Members Impacted by Wildfires in Southern California
Anthem is making temporary changes to health plan benefits to provide relief and ensure healthcare access for members who live in Los Angeles and Ventura counties in California and are impacted by the Palisades wildfire and windstorm conditions. The changes are in effect from January 7 through February 5, 2025.
The changes also apply to emergency responders who have been activated to the impacted area by their state or local agency but who do not live in the impacted area.
Some of the changes affect:
- Prescription refills
- Replacement of medical equipment or supplies
- Out-of-network coverage if an in-network provider is not available
More information can be found here.
For emergency assistance from Anthem, please contact 833-285-4030.
Anthem Plans are available for all U.S. employees. View the medical comparison below or on the 2025 At-A-Glance.
If you are an Anthem member, log in to your Anthem account at anthem.com/ca to monitor claims, review your Evidence of Benefits (EOBs), print ID cards, and search for in-network doctors and facilities. You can also download the Sydney app to easily manage your health care and connect with your Total Health Connections Family Advocate for support.
Anthem Blue Cross Exclusive | Anthem Blue Cross Preferred | Anthem Blue Cross HDHP | |||
---|---|---|---|---|---|
Anthem PPO Network In-Network Only |
Anthem PPO Network In-Network Only |
Out-of-Network | Anthem PPO Network In-Network Only |
Out-of-Network | |
Calendar Year Deductible | $100/Individual $300/Family |
$300/Individual $900/Family |
$2,000/Individual |
||
Percentage Co-Insurance | 10% | 20% | 35% | 10% | 30% |
Out-of-Pocket Maximum | $2,000/Individual $6,000/Family |
$2,000/Individual $6,000/Family |
$4,000/Individual $12,000/Family |
$5,000/Individual $10,000/Family |
$5,000/Individual $10,000/Family |
Doctor's Office Visits | $20 copay1 | $25 copay1 | 35% | 10% | 30% |
Specialist Office Visits | $30 copay1 | $35 copay1 | 35% | 10% | 30% |
Telehealth Visit | No charge with LiveHealth Online |
No charge with LiveHealth Online |
35% | 30% | |
Urgent Care | $20 copay1 | $25 copay1 | 35% | 10% | 30% |
Preventive Care Screening, Immunization, Radiology and Labs | No charge | No charge | 35% | No charge | 30% |
X-ray and Advanced Imaging | 10% | 20% | 35% | 10% | 30% |
Lab | 10% | 20% | 35% | 10% | 30% |
Outpatient Surgery and Procedures | 10% | 20% | 35% | 10% | 30% |
Emergency Room Services* | 10% after $100 copay (copay waived if admitted) |
20% after $100 copay (copay waived if admitted) |
20% after $100 copay (copay waived if admitted) |
10% | 10% |
Inpatient Hospital2 | 10% | 20% | 35% after $250 copay |
10% | 30% |
Outpatient Mental Health, Behavioral Health or Substance Abuse Services | $20 copay1 | $25 copay1 | 35% | 10% | 30% |
Inpatient Mental Health, Behavioral Health or Substance Abuse Services | 10% | 20% | 35% | 10% | 30% |
Chiropractor Visit | $20 copay 30-visit maximum per year |
20% 30-visit maximum per year |
35% 30-visit maximum per year |
10% 30-visit maximum per year |
30% 30-visit maximum per year |
Acupuncture Visit | $20 copay 30-visit maximum per year |
20% 30-visit maximum per year |
35% 30-visit maximum per year |
10% 30-visit maximum per year |
30% 30-visit maximum per year |
Physical, Speech and Occupational Therapy | 10% | 20% | 35% | 10% | 30% |
1Deductible does not apply 2Preauthorization required
* Learn about the No Surprise Act which limits unexpected billing when using an out-of-network doctor for emergency services
NOTE: Out-of-network coverage is based on Anthem Blue Cross’s maximum allowed amount.
All overviews summarize the Marvell Benefits Program. Full details of the benefit plan are contained in the official documents, which will govern in the case of any discrepancies.
Anthem Total Health Connections (Beginning January 1, 2025)
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
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.
Prescription Drugs + Mail Order
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.
Prescription Drugs | |||||
---|---|---|---|---|---|
Anthem Blue Cross Exclusive | Anthem Blue Cross Preferred | Anthem Blue Cross HDHP* | |||
Anthem PPO Network In-Network Only |
Anthem PPO Network In-Network Only |
Out-of-Network | Anthem PPO Network In-Network Only |
Out-of-Network | |
Out-of-Pocket Maximum | $2,000/Individual $6,000/Family |
$2,000/Individual $6,000/Family |
|
||
Pharmacy-Retail3 | Tier 1: $10/copay1 Tier 2: 10% ($30 min./$250 max.)1 Tier 3: 10% ($50 min./$250 max.)1 Tier 4: 10% ($100 min./$250 max.)1 |
Tier 1: $10/copay1 Tier 2: 20% ($30 min./$250 max.)1 Tier 3: 20% ($50 min./$250 max.)1 Tier 4: 20% ($100 min./$250 max.)1 |
Tier 1, 2, 3 and 4:
|
Tier 1: $10/copay1 Tier 2: 10% ($30 min./$250 max.) Tier 3: 10% ($50 min./$250 max.) Tier 4: 10% ($100 min./$250 max.) |
Tier 1, 2, 3 and 4:
|
Pharmacy-Mail Order3 Learn how to enroll here. |
Tier 1: $20 copay1 |
Tier 1: $20 copay1 Tier 2: 20% ($60 min./$500 max.)1 Tier 3: 20% ($100 min./$500 max.)1 Tier 4: 20% ($200 min./$500 max)1 |
Not covered | Tier 1: $20 copay1 Tier 2: 10% ($60 min./$500 max.) Tier 3: 10% ($100 min./$500 max.) Tier 4: 10% ($200 min./$500 max) |
Not covered |
*The HDHP Calendar Year Deductible is combined for Medical & Rx, except for Tier 1. Members are responsible for 100% of the discounted price for Tiers 2 through 4 until the Calendar Year Deductible is met. Then, the copay/cost share with Minimum Maximums will apply.
1Deductible does not apply 2Preauthorization required 3Coinsurance (including minimum and maximum allowed amounts) is per prescription 4Costs in excess of the plan's maximum allowed amount may apply (balance billing)
Description | |
---|---|
Tier 1 | Lowest Member Cost Share: These drugs offer the greatest value compared to others that treat the same conditions. |
Tier 2 | Medium Member Cost Share: These may be preferred brand drugs based on their effectiveness and value. Some are newer, more expensive generic drugs. |
Tier 3 | Higher Member Cost Share: These generally include non-preferred brand and generic drugs. They may cost more than drugs placed on lower tiers that are used to treat the same conditions. |
Tier 4 |
Highest Member Cost Share: Many drugs on this tier are specialty drugs used to treat complex, chronic conditions and may require special handling and/or management. |
You can use the below link to find the tier of your prescription. More guidance can be found in the 'Find your prescription tier' below.
- 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 this Anthem Prescription Drug List. This list can also be found within your Anthem account at anthem.com/ca and by searching 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.
Telemedicine Appointments With LiveHealthOnline.com
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
In-Network Provider Search for the Anthem Network
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.
Traveling Outside the Country
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.
Medical Second Opinion With 2nd.MD
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.
Supporting LGBTQIA Communities
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.
Preventive Care
Diabetes Prevention Program
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.
Concierge Cancer Care Program
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.
Autism Support
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.
Fertility Coverage
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.
Abortion Access
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.
Anthem Special Offers and Discounts
- Dental
- Hearing
- Eyewear
- LASIK
- Health and fitness
- Medicine and treatment
- Family
- Pets
Anthem Network Alerts
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.
Provider | Scheduled Contract Termination Date | Status | Microsite |
---|---|---|---|
Anesthesiologists of Middletown PC (CT) | 5/1/2025 | Pending | N/A |
Doc's Surgical Hospital (Los Angeles County, CA) |
4/15/2025 | Pending | N/A |
Cornerstone Specialty Hospitals | 4/1/2025 | Pending | N/A |
Southwestern Health Resources (TX) | 4/1/2025 | Pending | https://www.bcbstx.com/swhr |
Stamford Health |
3/25/2025 |
Resolved: In-Network |
|
American Vision Partners | 2/16/2025 |
Resolved: In-Network |
N/A |
Scripps Health | 1/1/2025 |
Out-of-network with continued negotiations |
|
Providence St. Joseph Health |
1/1/2025 |
Resolved: In-Network |
|
Sutter Health |
1/1/2025 |
Resolved: In-Network |
|
Community Healthlink (MA) | 1/1/2025 | Resolved: Out-of-Network | N/A |
Phoenix Children’s Hospital |
10/31/2024 |
Resolved: In-Network as of 2/8/25 |
|
HCA Far West |
10/1/2024 |
Resolved: In-Network |
N/A |
Wickenburg Community Hospital |
9/1/2024 |
Resolved: In-Network |
|
Baylor Scott & White Health |
7/1/2024 |
Resolved: In-Network |
|
Cottage Health System |
7/1/2024 |
Resolved: In-Network |
N/A |