Professional Services
Covered services are paid at 70% of Eligible Expenses after the annual deductible has been met.
The following professional services are covered, if deemed to be Medically Necessary Covered Health Services as determined by Anthem Blue Cross:
  • Services of a physician, surgeon or assistant surgeon
  • Services of an anesthetist or anesthesiologist in connection with surgery
  • Services of a consulting physician when requested by your doctor
  • Constant care services rendered by a physician when you are in critical condition
  • Physician visits to a hospital or skilled nursing facility during a covered inpatient confinement
  • Visits to your doctor's office or physician house calls for treatment of illness, disease or injury
  • Radiation therapy
  • Outpatient diagnostic X-rays and lab exams
  • Injections, inoculations and immunizations
  • Physician services in the outpatient department of a hospital, ambulatory surgical facility or short-stay surgical unit
  • Routine physical examinations
  • Routine or diagnostic Pap smears and mammograms
  • Well-baby care
  • Services of a licensed physical therapist for a covered inpatient hospital or skilled nursing facility confinement. (Benefits are limited to one visit per day per specialty. Benefits for visits during a skilled nursing facility confinement are limited to $50 during each confinement.)