MEDICAL INSURANCE




The CHEIBA Trust and the CHEIBA Trust Members offer you four medical insurance
plans from which to select. Please carefully review the Multi-Option Plan
Summary located in the pocket of this booklet regarding the various medical
insurance plans before you make your selection. After you enroll, you will receive
your membership card. It will be mailed to your home. If you do not receive your

card, call the Customer Service number as noted on the Plan Contacts Page at the

beginning of this book.



ANTHEM BLUE CROSS AND BLUE SHIELD/HMO COLORADO

Your choices include:





BlueAdvantage
Prime Blue

Point of
Priority PPO

Service Plan
Plan







Lumenos High
Blue Priority

Deductible
HMO Plan

Health Plan






- 11 -

MEDICAL INSURANCE



BlueAdvantage
PRIME Blue Priority PPO
Blue Priority HMO
Lumenos PPO
Description
In Network
Out of Network (POS)
PPO In Network
Non-PPO Out of Network
HMO In Network Only
PPO In Network
Non PPO Out of Network
(HMO)
Grandfathered Health Plan
NO
NO
NO
NO

You Pay
You Pay




$500 Individual
$400 Individual
$1,000 Individual
$2,500 Individual
$2,500 Individual
Annual Deductible
None
$2,000 Individual
$1,000 Family
$800 Family
$2,000 Family
$5,000 Family
$5,000 Family
$6,000 Family
Out-of-Pocket Annual
$2,000 Individual
$3,000 Individual
$2,000 Individual
$4,000 Individual
$4,000 Individual
$2,500 Individual
$5,000 Individual
Maximum
$4,000 Family
$6,000 Family
$4,000 Family
$8,000 Family
$10,000 Family
$5,000 Family
$10,000 Family
Al copayments (including Rx
Al copayments (including Rx
Out of Pocket Annual
Al copayments (including Rx
Deductible, Coinsurance
copayments), Deductible and
Deductible & Coinsurance
copayments), deductible and
Deductible
Deductible & Coinsurance
Maximum Includes
copayments)
Coinsurance
coinsurance
Physician Selection
PCP required
Unrestricted
PCP required
Unrestricted
PCP required
Unrestricted
Unrestricted
Medical Office Visits

$10 copayment for Designated Provider

Preventive Care Covered 100%


Primary Care
$20 copayment per visit
30% after deductible
(Primary/Specialist) / 15% after
$20 copayment per visit
0% after deductible
30% after deductible

35% after deductible
Specialist
$40 copayment per visit
deductible for Participating Providers
$60 copayment per visit
0% after deductible
LiveHealth Online
$20 copayment per visit
Not Covered
$10 copayment per visit
Not Covered
$20 copayment per visit
0% after deductible
30% after deductible
(Telemedicine)
Urgent Care
$50 copayment per visit
$50 copayment per visit
15% after deductible
35% after deductible
$60 copayment per visit
0% after deductible
30% after deductible
Emergency Room
$150 copayment per visit
$150 copayment per visit
15% after deductible
15% after deductible
$250 copayment per visit
0% after deductible

$250 copayment + 20% after
Inpatient Hospital
$600 copayment per admission
30% after deductible
15% after deductible
35% after deductible
0% after deductible
30% after deductible
deductible
Outpatient Surgery


$250 copayment + 20% after



Hospital Based Facility
$125 copayment per visit
15% after deductible
deductible (Hospital)
0% after deductible
30% after deductible

30% after deductible
35% after deductible
Freestanding Facility
$60 copayment per visit
10% after deductible
$250 copayment (Freestanding)
Labs covered 100% /X-Ray $60
10% after deductible (Freestanding)
copayment (Freestanding)
Outpatient Lab & X-Ray
Covered 100%
30% after deductible
35% after deductible
0% after deductible
30% after deductible
15% after deductible (Hospital Based)
$250 copayment + 20% after
deductible (Hospital)
Advanced Imaging


$250 copayment + 20% after
(MRI/MRA/PET/CT Scans)




15% after deductible
deductible
0% after deductible
30% after deductible
Hospital Based Facility
$120 copayment per procedure
30% after deductible
35% after deductible

10% after deductible
$250 copayment per procedure
Freestanding Facility
$60 copayment per procedure
Drug Formulary
Essential Drug Formulary
Essential Drug Formulary
Essential Drug Formulary
Essential Drug Formulary
$200 Individual / $400 Family Deductible 2



Prescriptions Retail
Tier 1-$10 copayment
Tier 1-$10 copayment
Not Covered
Not Covered
Tier 1-$15 copayment
0% after deductible
30% after deductible
(30-day supply)
Tier 2-$40 copayment
Tier 2-$40 copayment
Tier 2-$40 copayment
Tier 3-$60 copayment
Tier 3-$60 copayment
Tier 3-$60 copayment
Tier 1-$10 copayment
Tier 1-$10 copayment
Tier 1-$15 copayment
Prescriptions Mail Order
Tier 2-$80 copayment
Not Covered
Tier 2-$80 copayment
Not Covered
Tier 2-$80 copayment
0% after deductible
Not covered
(90-day supply)
Tier 3-$120 copayment
Tier 3-$120 copayment
Tier 3-$120 copayment
Specialty Drugs ¹ (Tier 4)
30% coinsurance to max $125
Not Covered
30% coinsurance to max $250
Not Covered
30% coinsurance to max $250
0% after deductible
Not covered
(30-day supply)
¹ Not all specialty drugs on Tier 4 are subject to the Tier 4 coinsurance. Certain specialty drugs may be subject to the Tier 1, 2 or 3 copayment.
₂ Tier 2 and Tier 3 retail pharmacy, specialty pharmacy and/or home delivery drugs are first subject to a deductible. Once satisfied, then services are subject to the applicable copayment per prescription.
- 12 -

MEDICAL INSURANCE

PRESCRIPTION DRUG BENEFIT
Prescription drug coverage is included with all medical plans. Your
prescription drug coverage has three copayment tiers, with generic
medications having the lowest copayments. You can save more on
medications you take regularly, sometimes called maintenance medications,

by using the mail order pro

gram.

Your plans use a drug list called a formulary to help determine your copayment for each prescription. The drugs on your formulary were
selected to give you the highest level of coverage under your prescription drug benefit.

What is the Essential Drug List?
The Essential Drug List is a list of brand-name and generic prescription medications that have been selected and are periodically
reviewed through Anthem’s Pharmacy & Therapeutics process for proven effectiveness, high quality, and affordability. The Essential
Drug List includes all of the essentials, but is a focused list that offers pharmacy cost savings while ensuring there are no gaps in care.

What can a member do if their medication isn’t on the Essential Drug List?
If your medication is not on the Essential Drug List, there may be a brand alternative, a generic equivalent or OTC option. When you
search the Essential Drug List, you will see the generic equivalent if available; however, OTC options will not be displayed. If an
alternative isn’t listed, members should talk with their doctor or pharmacist about whether another medication that is included on the
Essential Drug List or an OTC may be right for them.
Non-formulary medications can be requested through the formulary exception process. If a medication a member takes isn’t covered on
the Essential Drug List, the member or doctor can ask us to keep covering it by asking for a formulary exception. The process is the
same as any Prior Authorization request. The member or doctor can call Member Services at the number on the ID card. Members can
also go online to find the preapproval fax form to ask for a formulary exception. In most cases, the prescribing doctor is first asked
whether the member has tried two formulary alternatives. If not appropriate or available, Anthem will review the clinical requirements and
concerns presented by the doctor. For some classes and most specialty medications, drug-specific prior authorization criteria may be
used. This is done to ensure specific alternatives are tried or the medication is used for the correct indication.

How can I search the Essential Drug List?
At www.anthem.com/pharmacyinformation select the Essential 4-tier Drug List. You can search for medications, and see which drugs are
covered and at what tier level. You can enter the name of the drug or you can browse through the categories shown on the screen. Once
you are on the drug details page, you’ll see the tier level listed. If you see “NF” that means the drug is non- formulary and not covered.
- 13 -

MEDICAL INSURANCE

PRESCRIPTION DRUG BENEFIT

Blue Advantage HMO/POS, Prime Blue Priority PPO, Blue Priority HMO and Lumenos HDHP
Your ID Card is your membership card for both doctor visits and prescriptions. The prescription drug benefit is provided through Anthem's
Pharmacy Benefits Manager (PBM) and includes a formulary plan with four tiers:

Tier 1 Generics - these drugs are simply copies of brand-name drugs. Brand-name and generic drugs have the same active ingredients,
strength and dose. The FDA requires that generic drugs meet the same high standards for purity, quality, safety and strength. With
generics, you get the same quality for less money.
Tier 2 Preferred Brand - these are drugs for which generic equivalents are not available. They have been in the market for a time and are
widely accepted. They cost more than generics, but less than non-preferred brand-name drugs.
Tier 3 Non-Preferred Brand - these drugs are generally higher-cost medications that have recently come on the market. In most cases,
an alternative preferred or generic medication is available.
Tier 4 Specialty Drugs - these are prescription medications used to treat complex, chronic conditions that may require special handling
and/or management. It is important to note the following:

o Not all specialty drugs on Tier 4 are subject to the Tier 4 coinsurance. For example, capecitabine, a drug used to treat cancer, is
generic so a member could obtain this prescription for the Tier 1 copayment.

o Some specialty drugs are considered Retail Pharmacy Drugs and are not on the Exclusive Specialty List. These drugs are not
required to be obtained through the specialty pharmacy. An example of this would be Arixtra, a drug used to prevent blood clots.
The formulary includes prescription drugs that have been approved for use by HMO Colorado and is updated on a quarterly basis. You can review
this formulary by going to www.anthem.com.


NOTE: Prescription drugs will always be dispensed as ordered by your provider and by applicable State Pharmacy Regulations, however,
you may have higher out-of-pocket expenses. You may request, or your provider may order, the brand-name drug. However, if a generic
drug is available, you will be responsible for the cost difference between the generic and brand-name drug, in addition to your Tier
copayment. The cost difference between the generic and brand-name drug does not contribute to the out-of-pocket annual maximum. (Tier
1 generic copayment is not applicable if you are enrolled in the Lumenos HDHP)
Diabetic supplies/prescriptions and asthma inhalers/prescriptions will be covered at no cost to you.
Members taking specialty drugs must order them through Accredo at 1-800-870-6419, which offers a full-service pharmacy that ships
medications to members or their provider, up to a 30-day supply, by overnight mail or common carrier.
Mail Order/Home Delivery: If you need maintenance medications for ongoing conditions such as asthma, diabetes, high blood pressure, etc., you
may want to use home delivery service. This service offers you the convenience of having prescriptions delivered directly to the home, office or
anywhere in the United States. Ordering your maintenance medications through home delivery eliminates monthly trips to the pharmacy and allows
you to receive more days’ supply with fewer copayments. Typical savings are at least one copayment for each prescription.

Prescription drugs purchased from out-of-network pharmacies are not covered.


Call Customer Service at: ...................... 1-800-542-9402
If you have questions
or
Go to the website: ............................ www.anthem.com



- 14 -

MEDICAL INSURANCE

BLUE ADVANTAGE HMO/POS
The Point-of-Service (HMO/POS) Plan includes both in-network and out-of-network benefits. A member has the option for both in-network and out-
of-network benefits based on the provider rendering the service.

Services rendered by a non-HMO provider are processed under the POS benefits and are subject to the applicable deductible and coinsurance.
This option is designed to give HMO members the choice to use a non-HMO provider and still receive a level of benefits. A referral from your HMO
primary care provider is not needed to seek services from a non-HMO provider.

Additionally, out-of-network services may be subject to Balance Billing. If you have any questions regarding out-of-network services, please read
the plan description carefully or call for assistance.

PHYSICIAN SELECTION
You must select a primary care physician (PCP) for yourself and each covered Dependent in order to be eligible for in-network benefits. You have
the right to designate any primary care provider who participates in the network and who is available to accept you or your family members. For
children, you may designate a pediatrician as the primary care provider. Members are not required to obtain a referral from their PCP to see an in-
network specialist. However, Anthem does encourage you to ask your PCP for an in-network referral recommendation.

To search for primary care providers and participating health care professionals online, please visit www.anthem.com:
 Select Find A Doctor

Select Search by selecting plan or network

Select a state: (choose from drop down menu)

Select a plan/network (Medical Network): HMO

Choose Select and Continue

Complete fields for provider type, specialty and location
 Select: Search
PRIME BLUE PRIORITY PPO
This choice provides a flexible plan option that allows you access to three different levels of providers, each with different out-of-pocket costs:
Level 1: Blue Priority Designated providers are either PCP’s or specialists. A Designated PCP or Designated specialist has the lowest out-of-
pocket costs with a simple co-pay. Blue Priority Designated providers are located in the following counties: Adams, Arapahoe, Boulder
(including Longmont), Broomfield, Denver, Douglas, Elbert, El Paso, Fremont, Jefferson, La Plata, Montezuma, Pueblo, Summit and Teller.
Level 2: Providers in Anthem’s large, traditional PPO network may serve as PCP’s and specialists.
Level 3: Nonparticipating providers have the highest out-of-pocket costs.
Additionally, out-of-network services may be subject to Balance Billing. If you have any questions regarding out-of-network services, please read
the plan description carefully or call for assistance.
NOTE: If you live in a rural area and there are no PPO providers within a reasonable distance from you, you may request an authorization to see an out-of-
network provider. If approved, benefits will be applied at the in-network level. Please contact Anthem Blue Cross Blue Shield at 1-800-542-9402 for assistance.

PHYSICIAN SELECTION
You must select a Blue Priority Designated primary care physician (PCP) for yourself and each covered Dependent. However, you may receive care
from any provider that participates in the network. You will pay less if you receive care from a Designated provider.
Members are not required to obtain referrals from their PCP to see an in-network specialist. . However, Anthem does encourage you to ask your
PCP for an in-network referral recommendation.

To search for primary care providers and participating health care professionals online, please visit www.anthem.com:


Select Find A Doctor

Select Search by selecting plan or network

Select a state: (choose from drop down menu)

Select a plan/network (Medical Network): PPO (Level 2 & 3 providers) / For Designated Blue Priority (Level 1) providers, please select the
Blue Priority PPO

Choose Select and Continue

Complete fields for provider type, specialty and location
 Select: Search


- 15 -

MEDICAL INSURANCE

BLUE PRIORITY HMO
The Blue Priority HMO Plan includes in-network benefits only.
Members must choose a primary care physician from the Blue Priority network. Providers are located in the Denver metro area, which includes
Adams, Arapahoe, Boulder, Broomfield, Denver, Douglas and Jefferson counties, as well as Elbert, El Paso, Teller, Fremont, La Plata, Montezuma,
Pueblo, Summit counties and the city of Longmont.
PHYSICIAN SELECTION
You must select a primary care physician (PCP) for yourself and each covered Dependent in order to be eligible for in-network benefits. You have
the right to designate any primary care provider who participates in the network and who is available to accept you or your family members. For
children, you may designate a pediatrician as the primary care provider.
Your primary care physician is your personal provider who coordinates your care within the Blue Priority HMO network. Referrals to see a
specialist are required.
To search for primary care providers and participating health care professionals online, please visit www.anthem.com:
 Select Find A Doctor

Select Search by selecting plan or network

Select a state: (choose from drop down menu)

Select a plan/network (Medical Network): Blue Priority HMO

Choose Select and Continue

Complete fields for provider type, specialty and location
 Select: Search
LUMENOS HIGH DEDUCTIBLE HEALTH PLAN
This choice is a High Deductible Preferred Provider (PPO) plan option which includes in and out-of-network coverage.

Members must pay their annual deductible¹ during the plan year before the plan helps pay for costs. This includes costs for medical and prescription
drug expenses. All in-network preventive care services are 100% covered.
In-network doctors have a pre-negotiated rate with Anthem Lumenos, so your expenses will be less if you use in-network doctors.
Example: If you go to a doctor for a sore throat before you meet the deductible, you pay the full (negotiated) cost of the office visit and any tests your physician
orders and prescription drugs prescribed.

This plan can be combined with a health savings account (HSA) to allow you to pay for qualified, out-of-pocket medical expenses on a pre-tax basis.
An HSA account is a personal, portable account and remains in your control regardless of your employment. An HSA can be established through
any qualifying financial institution. Please contact your financial advisor or banking institution for additional information.
¹ The annual deductible under the Lumenos HDHP is non-embedded. For employees with dependents, this means that all family members’ out-of-pocket
expenses count toward the family deductible until it is met. It does not matter if one person incurs all the expenses that meet the deductible or if two or
more family members contribute toward meeting the family deductible.

PHYSICIAN SELECTION
You can select PPO physicians who have entered into an agreement with Anthem Blue Cross and Blue Shield to provide care at negotiated rates, or
you may select the physician of your choice outside of the PPO network. However, out-of-pocket expenses may be significantly higher if you select
an out-of-network provider.

To search for primary care providers and participating health care professionals online, please visit www.anthem.com:


Select Find A Doctor

Select Search by selecting plan or network

Select a state: (choose from drop down menu)

Select a plan/network (Medical Network): Lumenos PPO

Choose Select and Continue

Complete fields for provider type, specialty and location
 Select: Search
- 16 -

MEDICAL INSURANCE


CUSTOM PLUS HEALTH PLAN


Closed to new enrollment effective January 1, 2010.

This is a traditional major medical plan.

Physician Selection
There are no restrictions regarding the choice of physicians under this plan. Please note, if you select a provider
not participating in the Traditional Participating Network, you may be subject to Balance Billing.

Prescription Drug Benefit
Prescription drugs are covered at 80% after the deductible is met. There is no separate prescription card.
Prescription benefits are reimbursed to you after you submit a medical expense claim form found on
www.anthem.com. Claim forms are provided through Anthem Blue Cross and Blue Shield of Colorado or through
your Human Resources/Benefits Office.
Medical Benefits
Custom Plus
Description
No Defined Network
$800 Individual
Annual Deductible
$1,600 Family
$3,800 Individual
Annual Maximum Out-of-Pocket
$7,600 Family
Unrestricted; greater benefits with Traditional Participating Network
Physician Selection
provider
Physician Services
80% after deductible (based on the maximum benefit allowance)
Hospital
80% after deductible (based on the maximum benefit allowance)
Outpatient Surgery
80% after deductible (based on the maximum benefit allowance)
Outpatient Lab
80% after deductible (based on the maximum benefit allowance)
Prescriptions
80% after deductible
Retail & Mail Order

If you want to complete your enrollment forms, review the Multi-
Option Plan Summary or review this Benefit Booklet, reference
Custom Plus
this plan name:
If you want to search for information (like searching for a doctor)
Major Medical/ Traditional Provider Network
on the anthem.com website, reference this plan name:
Call Customer Service at: ...................... 1-800-542-9402
If you have questions
or
Go to the website: ............................ www.anthem.com






- 17 -

MEDICAL INSURANCE

MyAnthem™
Tired of paperwork and phone calls? Anthem offers its members a useful website. Register with anthem.com to
get online access to your benefits. MyAnthem™ takes the hassle out of your health care and allows you to get
your information when you need it. Use MyAnthem™ to:


Find a doctor

Search for a doctor, specialist, urgent care or hospital close by.




Get your ID card

Share, fax, or email your ID card.



Check your claims

Find out what your doctor billed, how much was paid and if you owe anything.



Estimate your costs

See what nearby doctors and facilities charge for a procedure. You can

compare providers on cost and quality.



View your medical benefits

See your copays, deductibles, your percentage of the costs, and other important plan

benefit information.



Manage prescription benefits

Check the cost of drugs, get refills or switch to our home delivery program.



Access your Health Record

View your Health Record and share with your doctors whenever you go.






DO YOU HAVE A SMARTPHONE?



Using Anthem’s free mobile app can make it easier than ever to manage your health care.

1. Go to the app store on your smartphone or mobile device.

2. Search for Anthem Anywhere

3. Select the app and start the free download.

To use the mobile application, you must be registered on Anthem’s secure member site

and have a username and password.



- 18 -

MEDICAL INSURANCE



- 19 -

MEDICAL INSURANCE

ConditionCare
If you or one of your dependents have diabetes, coronary artery disease (CAD), heart failure (HF), chronic obstructive
pulmonary disease (COPD) or asthma, ask Anthem about their programs to help manage these conditions. ConditionCare is
included in your health plans and offers valuable tools and information that could make a real difference as you strive for
better health.
 24-hour, toll-free access to registered nurses to answer your questions and provide you with support and education on
how to better manage your condition
 Specially designed condition-specific care diaries, self-monitoring charts, self-care tips and other easy-to-use
empowerment materials.
For information about Anthem’s ConditionCare programs, call toll-free 1-877-236-7486 or go to www.anthem.com and
select Health & Wellness. Various conditions are listed for your information.
Future Moms
The program, Future Moms, is there for our moms-to-be. At such an important time in your life, you’ll have access to extra
pre- and post-natal, confidential support and education any time of the day or night! Even with terrific care from your doctor,
you may have questions that come up between visits. Nurses are available for you to talk with around the clock. You may
also benefit from:
 Maternity care materials including Your Pregnancy Week By Week, which is a helpful prenatal care book, free for just
enrolling in the plan
 A confidential questionnaire to evaluate your risk for premature delivery
 Useful tools to help you, your doctor and your Future Moms nurse track your pregnancy and identify possible risks
Anthem’s goal is to help you and your doctor work together to have a healthy pregnancy and a healthy new baby. Remember,
your doctor is your best source of information about your pregnancy and your health, and Future Moms is here to help along
the way.
To reach Future Moms, call toll-free 1-800-828-5891 or go to www.anthem.com and select Health & Wellness
24/7 NurseLine
Whether it’s 3 p.m. or 3 a.m., wouldn’t it be great if you could speak with an experienced nurse about any of your health
questions or issues? Now you can!

The 24/7 NurseLine can assist you in making more informed health care decisions via confidential, one-on-one conversations
with a registered nurse, any time of the day or night. Whenever you call, you can easily access a library of audio tapes on a
range of topics related to your health care. Or, if you prefer, you can talk to a nurse about hundreds of health issues ranging
from asthma to zinc, like: Coughs Abdominal Pain Weight Loss Colds Children’s Health Sexually Transmitted Diseases.
Fever Food & Diet Headache Smoking Women’s Health . . . and much more! Bilingual nurses, the Language Line and
TTY/TDD relay services for the hearing impaired are also available.

For confidential health information from a registered nurse 24-hours a day, 365 days a year, call 1-800-337-4770 or go to
www.anthem.com and select Health & Wellness.

24/7 NurseLine is not an emergency response system. In a medical emergency, call 911 or your local emergency service
number.
To reach 24/7 NurseLine, call toll-free 1-800-337-4770 or go to www.anthem.com and select Health & Wellness.
Colorado QuitLine
Whether you are thinking about quitting tobacco or have already quit, Colorado QuitLine is a FREE program and here to help
you. Join QuitLine today and receive free:

 Personally tailored quit program
 Nicotine replacement therapy
 Support network
 Telephone coaching
 Tools and tips based on the latest research

Website:................................................................................................................................................ www.coquitline.org
Phone: ........................................................................................................................................................ 1-855-891-9988
- 20 -

MEDICAL INSURANCE

LIVEHEALTH ONLINE

What is LiveHealth Online®?
Use LiveHealth Online for common health concerns like colds, the flu,
fevers, rashes, infections, allergies and more! It’s faster, easier and more
convenient than a visit to an urgent care center.

LiveHealth Online is part of your health plan benefits. The cost of a LiveHealth Online visit is the same or less
than a primary care office visit. With LiveHealth Online, you have a doctor by your side 24/7. LiveHealth Online
lets you talk face-to-face with a doctor through your mobile device or a computer with a webcam. No
appointments, no driving and no waiting at an urgent care center.

How does LiveHealth Online work?
When you need to see a doctor, simply go to livehealthonline.com or access the LiveHealth Online mobile app.
Select the state you are located in and answer a few questions. Best of all, LiveHealth Online is a part of your
health plan. So, the cost of a LiveHealth Online visit is the same or less than a primary care office visit.
Establishing an account allows you to securely store your personal and health information. Plus, you can easily
connect with doctors in the future, share your health history and schedule online visits at times that fit your
schedule. Once connected, you can talk and interact with the doctor as if you were in a private exam room.

How do I access LiveHealth Online?
Sign up at www.LiveHealthOnline.com
or
Download the LiveHealth Online mobile app for free on your mobile device by visiting the App StoreSM or Google
PlayTM.

How do I pay for a LiveHealth Online session?
LiveHealth Online accepts Visa, MasterCard and Discover cards as payment for an online visit with a doctor.
Please keep in mind that charges for prescriptions aren’t included in the cost of your doctor’s visit.

Do doctors have access to my health information?
LiveHealth Online doctors can only access your health information and review previous treatment
recommendations and information from prior LiveHealth Online visits.
If you are using LiveHealth Online for the first time, you will be asked to answer a brief questionnaire about your
health before you speak with a doctor. Then the information from your first online visit will be available for
future LiveHealth Online visits.

Who do I get in touch with if I still have questions?
You can email, customersupport@livehealthonline.com or call toll free at 1-855-603-7985.

If you send us an email, please be sure to include:
Your name
Your email
A phone number where you can be reached

LiveHealth Online should not be used for emergency care. If you experience a medical emergency, call 911
immediately.



- 21 -

MEDICAL INSURANCE

LIVEHEALTH ONLINE PSYCHOLOGY

If you’re feeling stressed, worried or having a tough time, you may need someone to
speak with. Now you can see a licensed therapist using LiveHealth Online Psychology.
Talk with a therapist from your home or wherever you have internet access. It’s
quick, easy and private. Just download the free LiveHealth Online app to your mobile
device or visit www.livehealthonline.com on a computer with a webcam.

How do I schedule my first appointment with a psychologist or therapist using LiveHealth Online?
For your first visit, set up a time by going online, using the mobile app or calling LiveHealth Online:
Online: Visit www.livehealthonline.com and sign up or log in. Once you have logged in, select LiveHealth
Online Psychology. Next choose from available therapists after seeing their backgrounds and set up a visit.
Mobile App: Download the free LiveHealth Online mobile app and then sign up or log in. Once you have logged
in, select LiveHealth Online Psychology and choose an available therapist after checking out their qualifications
Phone: Call 1-844-784-8409 from 7 a.m. to 11 p.m.

In most cases, you can make an appointment to see a therapist within four days or less. LiveHealth Online will
send you an email confirming your appointment. You must be at least 18 years or older to visit with a therapist
online. Psychologists and therapists using LiveHealth Online Psychology do not prescribe medications.

How do I set up a follow up appointment?
At the end of your first visit, you can set up a future visit with the therapist if both of you feel it is needed. You
always have the choice of the therapist you would like to see.

How long does a visit usually last?
A typical visit with a psychologist or therapist using LiveHealth Online Psychology is about 45 minutes.

How do I pay for a LiveHealth Online session?
Depending on your coverage, the cost may be similar to what you would pay for an office visit, considering your
benefits, copay or coinsurance. You can pay your share of the visit using a Visa, Mastercard, Discover or American
Express credit or debit card. You will see what you owe before you start a visit and the cost is charged to your
credit card. The cost is the same no matter when you have the visit - whether it’s a weekday, the weekend,
evening or holiday.

What conditions can LiveHealth Online Psychology help with?
Therapists using LiveHealth Online can help you with stress, anxiety, depression, relationship or family issues,
grief, panic attacks and stress from coping with a sickness.

How do I know if a psychologist or therapist is in-network?
When you log in to www.livehealthonline.com, the providers you see on the website are part of the Anthem Blue
Cross and Blue Shield provider network. Make sure you select the state where you are currently located to view
the most up-to-date list of providers.

- 22 -