For years, Animation Guild members who subscribed to the Anthem Blue Cross Active PPO plan were required to receive their annual comprehensive physical exam at one of six UCLA Health Centers. The requirement has changed. Yes, you can now see any doctor for your annual physical; however, there are additional costs with not using a physician at a UCLA MPTF Health Center.
What is the cost difference between getting your physical at the UCLA MPTF Health Center or at a doctor not associated with the clinic?
If you are age 18 and older and you live in Los Angeles County, you will pay a $5 co-pay for your physical exam to be entirely covered at the UCLA MPTF Health Center. If you choose to get your annual physical exam with an in-network provider not associated with the MPTF Health Center, you will need to pay a $100 co-pay plus a 10 percent coinsurance up to the annual out-of-pocket maximum. Out-of-network providers will be paid at 50 percent of the allowable amount with a $100 co-pay. Additional non-covered services may be excluded so contact MPIPHP for additional details.
Does this mean I need to use a doctor at the UCLA MPTF Health Center for my primary care physician?
No. Basically, you have three choices.
- Choose a primary care physician from any of the doctors who practice at a UCLA MPTF Health Center near you. All your visits, including the annual physical exam, will be covered with a $5 co-pay.
- Choose any doctor you wish as your primary care physician, and get your annual physical exam with this provider. You will be required to pay a co-pay and additional out-of-pocket expenses as described above.
- Choose any doctor you wish as your primary care physician, but get your annual physical exam at the UCLA MPTF Health Center with any of the clinic doctors. Your annual exam will be covered with just a $5 co-pay, and you can send your results to your primary care physician for follow up.
For more information or additional questions about benefits visit www.mpiphp.org/home.
*Please note this issue does not apply to any member who has opted into Kaiser or HealthNet HMOs. For HMO plans, you will go to your assigned assigned primary care physician for your annual physical exam.