Southern California Drug Benefit Fund moves to the Anthem Blue Cross Medicare Advantage plan
Effective April 1, 2022, the Southern California Drug Benefit Fund will offer an Anthem Blue Cross (Anthem) Medicare Preferred (PPO) plan. Anthem will provide medical benefits for the Southern California Drug Benefit Fund retirees through the Anthem Preferred Provider Organization (PPO) product, which includes the National Access Plus benefit. The PPO plan allows members to receive services from any provider, as long as the provider is eligible to receive payments from Medicare.
Southern California Drug Benefit Fund members’ copay or coinsurance percentage will be the same whether their provider is in- or out-of-network. Locally or nationwide, doctors or hospitals, member share-of-cost (SOC) does not change.
Non-contracted providers may continue treating Southern California Drug Benefit Fund members and will be reimbursed 100% of Medicare’s allowed amount for covered services, less any member share of cost (SOC).
The Medicare Advantage plan offers the same medical and hospital benefits that Medicare covers including additional benefits that Medicare does not cover, such as LiveHealth Online* and SilverSneakers.*
The prefix on the Medicare Advantage ID cards is MBL.
Detailed prior authorization requirements are also available to contracted providers by accessing the Provider Self-Service Tool at Availity.com.*
Providers will follow their normal claim filing procedures for Southern California Drug Benefit Fund member claims.
Providers may call Provider Services at 833-848-8730 for eligibility, prior authorization requirements, and any questions about the Southern California Drug Benefit Fund member benefits or coverage.
May 2022 Anthem Blue Cross Provider News - California