Medical

What you need to know

The Plan provides comprehensive medical coverage, including mental health and a substance abuse benefit, for active members and covered dependents, through Anthem Blue Cross Blue Shield. Active members will enroll in a preferred provider organization (PPO), meaning the Plan has negotiated lower rates with providers that are in-network. You can use any provider you choose, but you will pay more for care if you visit an out-of-network provider.

Looking for a provider near you?

Visit Anthem to search for a new provider or check to see if your current provider is still in-network. Be sure to use prefix DDW (WI members) or MMD (non-WI members) to begin your search.

You may also log in or create an account to order new ID cards, check on your claim status, pay bills, and more.

Find Care

Plan Highlights

Anthem provides members with a large network of providers for both Plan A and Plan B participants. Both plans work the same and cover the same range of services; however, certain out-of-pocket expenses may vary between the plans.

For a snapshot of what you pay for your medical coverage, refer to the chart below. For a full list of covered services, refer to your Plan Documents.

All copay and coinsurance costs shown are after your deductible has been met, if a deductible applies.

Plan A

Annual Deductible

Annual Out-of-Pocket Maximum

Primary Care

Preventive care (Annual physical, screenings, and immunizations)

Specialist visit

Diagnostic test (x-ray, blood work)*

Emergency room**

Urgent care

Inpatient hospitalization*

Outpatient hospitalization*

Mental health, behavioral health, or substance abuse services*

In-Network

Individual: $250
Family: $750

Individual: $1,500
Family: $1,500

10% coinsurance

No cost up to $300 per person, per year and no deductible. Deductible and 10% coinsurance apply to excess amount.

10% coinsurance

$50 copay per visit then 10% coinsurance. Deductible does not apply.

10% coinsurance

No charge

Out-of-Network

Individual: $500
Family: $1,500

Individual: $3,000
Family: $6,000

20% coinsurance

No cost up to $300 per person, per year and no deductible. Deductible and 10% coinsurance apply to excess amount.

10% coinsurance for chiropractic, acupuncture, and massage therapy.*** 20% coinsurance for all other services.

20% coinsurance

$50 copay per visit then 10% coinsurance. Deductible does not apply.

20% coinsurance

No charge

Plan B

Annual Deductible

Annual Out-of-Pocket Maximum

Primary Care

Preventive care (Annual physical, screenings, and immunizations)

Specialist visit

Diagnostic test (x-ray, blood work)*

Emergency room**

Urgent care

Inpatient hospitalization*

Outpatient hospitalization*

Mental health, behavioral health, or substance abuse services*

In-Network

Individual: $250
Family: $750

Individual: $1,500
Family: $3,000

20% coinsurance

No cost up to $300 per person, per year and no deductible. Deductible and 20% coinsurance apply to excess amount.

20% coinsurance

$50 copay per visit then 20% coinsurance. Deductible does not apply.

20% coinsurance

No charge

Out-of-Network

Individual: $500
Family: $1,500

Individual: $3,000
Family: $6,000

20% coinsurance

No cost up to $300 per person, per year and no deductible. Deductible and 20% coinsurance apply to excess amount.

20% coinsurance for chiropractic, acupuncture, and massage therapy***. 30% coinsurance for all other services.

30% coinsurance

$50 copay per visit then 20% coinsurance. Deductible does not apply.

30% coinsurance

No charge

*Precertification required to avoid benefit reduction

**Any copays and/or deductibles are not included in and do not count toward the total out of pocket.

***Chiropractic care limited to 36 visits per person, per calendar year; $1,500 massage therapy limit per person, per calendar year.

Telemedicine

LiveHealth Online, provided through Anthem, is a telemedicine benefit you can take advantage of to receive confidential and convenient care from the comfort of your home or on-the-go. Whether you need routine primary care, urgent care, or mental health services, you can connect with a board-certified physician 24/7 at no additional cost.

Learn More

For any additional questions or concerns regarding your medical benefits, reach out to Anthem directly at 833-952-2061, visit the Anthem website, or contact the Fund Office at 414-258-2336.