Effective January 1, 2019, Anthem Blue Cross and Blue Shield will offer three new Exclusive Provider Organization (EPO) plans in the Virginia Small Group market. The new EPO plans will use our KeyCare network which is currently also used by our PPO plans. The alpha prefix will be “VLX.”  One new EPO plan will be offered in each of the Bronze, Gold and Platinum metal levels of our health benefit plans. No Silver EPO plans will be offered at this time.

The notable difference from our standard PPO plans will be the exclusion of out-of-network benefits – except in medical emergencies and for certain authorized services. As such, the plans will be referred to as “open access” and will accordingly have the letters “OAEPO” in their names. The plans will not have gatekeeper referral requirements, and like our PPO and Point of Service (POS) plans, will have a PCP assignment requirement and only be sold OFF the exchange. The authorization process and reimbursement fee schedule will also follow what we have in place for PPO plans.

If you have questions, please contact our customer service area using the phone number on the back of the member’s ID card.

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December 2018 Anthem Provider Newsletter - Virginia