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Benefits Online > Health > Medical > PPO Plan



 
 
 
 
 
 
PPO Plan 

You have one PPO medical option under the Northrop Grumman Health Plan: the Anthem Blue Cross Preferred PPO.

The PPO option:

  • Enables you to go to any doctor or hospital, but you will pay less when you go to a doctor in the PPO network
  • Provides prescription drug coverage through Express Scripts
  • Provides health/substance abuse treatment coverage through ValueOptions
  • Provides a preventive care benefit, which means:
    • There is no dollar limit for in-network preventive care services, such as routine physicals and mammograms
      • Services must be coded as "routine" care by your physician to be covered (deductibles and coinsurance will not apply)
      • Services not coded as "routine" will not be eligible for preventive care reimbursement (will be paid as coded and covered; deductibles and coinsurance will apply
    • Office visit copayments still apply

PPO Medical Plan

  Anthem PPO
  In-network Out-of-network
Benefit plan year deductible $500 per individual/$1,000 per family $800 per individual/$1,600 per family
Office visit copay $20 (specialist visit: $40) 40% coinsurance
Coinsurance 20% 40%
Benefit plan year out-of-pocket maximum $3,000 per individual / $6,000 per family $5,000 per individual / $10,000 per family


 Key Points for the PPO Plan

  • You can go to any doctor or hospital you choose
  • You must meet your annual deductible before the plan pays benefits
  • Your deductible and level of benefits depends on whether you go to an in-network or out-of-network provider

Review this online interactive Anthem PPO Overview for general information about PPO plans.

 Blue Card Worldwide

As an Anthem member you take your health benefits with you when you travel outside the United States.

Review the Blue Card Worldwide® flyer for important information about finding care around the world and claims filing procedures for services rendered outside of the U.S.

 Guidlines for Transgender Surgeries

For detailed information about Anthem's Clinical Guidelines for transgender surgeries, click here.
Questions?
Call the Northrop Grumman Benefits Center (NGBC) at:
 
1-800-894-4194 
International:  718-354-1338
 
Monday - Friday
9:00 a.m. - 6:00 p.m. ET
 
Hearing impaired - please use the relay service
 through your provider.