County of Sonoma moves to Medicare Advantage with Anthem

Effective June 1, 2024, County of Sonoma in California will offer a Medicare Preferred (PPO) plan with Anthem.

Anthem will provide medical and prescription drug benefits for County of Sonoma retirees through the 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.

County of Sonoma 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 County of Sonoma members and will be reimbursed 100% of Medicare’s allowed amount for covered services.

The Medicare Advantage plan offers the same hospital and medical benefits that Medicare covers, while covering additional benefits that Medicare does not, 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 County of Sonoma member claims.

Providers may call Provider Services at 833-848-8730 for eligibility, prior authorization requirements, and any questions about the County of Sonoma member benefits or coverage.

We are excited for genuine collaboration with you, our care provider partners.