Assume after satisfying the $200 calendar year deductible, that you have a combined doctor and hospital bill for
covered charges in the amount of $10,000. By way of illustration, your out-of-pocket expense may be as follows:
If you use Anthem Blue Cross PPO doctors and hospital:
$10,000 of covered charges reduced to special, contract rate of $7,000. Your out-of-pocket cost would
be ten percent of $7,000 or $700.
If you use non-contracting doctors and hospital:
$10,000 of covered charges is reduced to $9,000, which is the amount determined by the Health Trust
to be reasonable and customary charges. From the $9,000 there is deducted a $200 hospital deductible,
applicable to hospitals which are not part of the Anthem Blue Cross PPO network. You will be reimbursed by the
Plan, eighty percent of $8,800, or $7,040. Your out-of-pocket expense will be $2,960, which is the
difference between total charges of $10,000 and Plan benefits of $7,040.