Your Medical Plans
You have three health plans to choose from, administered through Anthem of WI. Two plans are a qualified High Deductible Health Plan (HDHP) which provides you with access to a Health Savings Account. The third option includes copays at the time of a visit or when filling a prescription.
- HDHP 1
- HDHP 2
- CoPay Plan
High Deductible Health Plans (HDHPs) include an optional Health Savings Account (HSA) component. To learn more about HSAs, click here.
Prescription medication coverage is included in all plans with RxBenefits powered by Express Scripts. To learn more about prescription coverage, click here.
| Deductible | Coinsurance | Your Out-of-Pocket Limit |
|---|---|---|
| Deductible | Coinsurance | Your Out-of-Pocket Limit |
| You pay 100% until your deductible is met. In-network preventive care is covered 100% and not subject to the deductible. | Once you meet your deductible, the plan will begin to pay a percentage of your eligible healthcare costs. | Once you reach your out-of-pocket maximum, the plan will pay 100% of eligible expenses for the rest of the plan year. |
If You Have Family Coverage
Each family member enrolled on an Agropur medical plan has an individual deductible referred to as an embedded deductible. Your family deductible can be met by any combination of your family’s healthcare costs. One person within your family will not pay more than the individual deductible. Additionally, each family member enrolled on an Agropur medical plan has an individual out-of-pocket maximum.
How Your Medical Coverage Works
The plan allows you to visit any doctor or facility you choose—however, you will get the best coverage when you choose an in-network provider. To search for an in-network provider go to www.anthem.com/find-care.
- Select: Basic search as a guest
- Medical plan or network
- State where plan is offered: Wisconsin
- How you get health insurance: Medical (Employer-Sponsored)
- Plan or network:
- Within Wisconsin: Blue Preferred POS (Select Network)
- Outside Wisconsin: Blue Access PPO
The amount that the plan pays for covered services is based on the allowed amount. If an out-of-network provider charges more than the allowed amount, you may have to pay the difference. Always use an in-network provider for the best pricing and discounts.
Medical Plan Comparison
This is a summary of the benefits provided under each plan. Review the Summary of Benefits and Coverage (SBC) or Summary Plan Description (SPD) for more details.
Anthem of WI utilizes the networks:
- Within Wisconsin: Blue Preferred POS (Select Network)
- Outside Wisconsin: Blue Access PPO
| Medical | HDHP 1 | HDHP 2 | Copay Plan | |||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Medical | HDHP 1 | HDHP 2 | Copay Plan | |||||||||
| In-Network | Out-of-Network | In-Network | Out-of-Network | In-Network | Out-of-Network | |||||||
| Annual Deductible | ||||||||||||
| Individual | $3,300 | $4,000 | $5,000 | $6,000 | $1,500 | $3,000 | ||||||
| Family | $6,600 | $8,000 | $10,000 | $12,000 | $3,000 | $6,000 | ||||||
| Coinsurance | 20% | 40% | 20% | 40% | 20% | 40% | ||||||
| Annual Out-of-Pocket Maximum | ||||||||||||
| Individual | $4,000 | $4,700 | $6,000 | $7,000 | $3,000 | $6,000 | ||||||
| Family | $8,000 | $9,400 | $12,000 | $14,000 | $6,000 | $12,000 | ||||||
|
Services What you pay after meeting the deductible |
In-Network | Out-of-Network | In-Network | Out-of-Network | In-Network | Out-of-Network | ||||||
| Preventive Care | Covered 100% | 40% | Covered 100% | 40% | Covered 100% | 40% | ||||||
|
Telehealth via LiveHealthOnline Medical Therapy & Psychiatry |
You pay $59 You pay 20% |
You pay $59 You pay 20% |
You pay $0 You pay $60 |
|||||||||
| Primary Care Office Visit | You pay 20% | You pay 40% | You pay 20% | You pay 40% | $30 | You pay 40% | ||||||
| Specialist Office Visit | You pay 20% | You pay 40% | You pay 20% | You pay 40% | $60 | You pay 40% | ||||||
| Urgent Care | You pay 20% | You pay 40% | You pay 20% | You pay 40% | $75 | You pay 40% | ||||||
| Emergency Room | You pay 20% | You pay 20% | $250 | |||||||||
| Hospitalization | You pay 20% | You pay 40% | You pay 20% | You pay 40% | You pay 20% | You pay 40% | ||||||
Connect with the care that’s right for you
The Find Care tool helps you search for doctors and compare costs
Choosing a provider you trust is important — and choosing one in your plan’s network can help keep your costs down. Finding high-quality, cost-effective care is simple when you use the Find Care tool on the Sydney Health mobile app or anthem.com.
- LiveHealth Online | No appointment necessary to meet with a doctor to assess your condition. Visit a licensed therapist in four days or less. Consults a psychiatrist within two weeks.
- Building Healthy Families | Personalized and digital support whether you’re trying to conceive, expecting, or raising children.
- 24/7 Nurseline | Access to a registered nurse to help find a provider, give a referral to LiveHealth Online for a video visit with a board-certified doctor, enroll in health management programs, and offer resources.
- Case Management | Nurses supported by clinical experts to help during stressful times by advocating for your treatment, reviewing your health plan, and connecting you with resources to ensure the best care possible.
What Can You Do with Anthem’s Sydney App?
• Find A Doctor and Check Your Costs
• View Your Claims
• See All Your Health Coverage Benefits
• View And Use Your Anthem Digital ID Card
• Use The Chat To Find Answers To Your Questions
• Stay Connected To Healthy Living
Sydney Mobile App
Find Care via Find Care via Sydney
24-7 NurseLine
Building Healthy Families
Find Care via Desktop
Health Care Summary Guide
HDHP Plans Pharmacy Benefits Coverage
Copay Plan Pharmacy Benefit Coverage
Copay Plan SBC Blue Preferred WI Residents 2025
Copay Plan SBC Blue Access All States Except WI 2025
HDHP 2 SBC Blue Access All States Except WI 2025
HDHP 1 SBC Blue Access All States Except WI 2025
HDHP 1 SBC Blue Preferred WI Residents 2025
HDHP 2 SBC Blue Preferred WI Residents 2025
