Blue Shield Bronze 60 PPO

This plan are for those who are looking to comply with the individual mandate of the Affordable Care Act.

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Blue Shield Bronze 60 HDHP PPO - Effective 2018
Health Insurance Plans for Individuals and Families

This plan are for those who are looking to comply with the individual mandate of the Affordable Care Act. Blue Shield of California There is an individual calendar deductible of $6,550 and a family deductible of $13,100. Most services require you to meet your calendar deductble first except preventive care services, such as routine physical exams and mammogram screenings, are at no charge. This is the most popular Blue Shield plan in California and will satisfy your mandated individual health insurance requirement also known as "minimum essential health coverage ".

Plan NameBronze 60 HDHP PPO
Combined Medical & Drug Deductible Individual: $4,800 Family: $9,600
   
Annual Out-of-PocketBronze 60 HDHP PPO
Out of Pocket Max for Med and Drug EHB Benefits (Total) Individual: $6,550 Family: $13,100
Emergency HealthBronze 60 HDHP PPO
Urgent Care Centers or Facilities40% Coinsurance after deductible
Emergency Room Services40% Coinsurance after deductible
Emergency Transportation/Ambulance40% Coinsurance after deductible
Home Health CareBronze 60 HDHP PPO
Home Health Care Services40% Coinsurance after deductible
Hospitalization ServicesBronze 60 HDHP PPO
Inpatient Physician and Surgical Services40% Coinsurance after deductible
Habilitation Services40% Coinsurance after deductible
Inpatient Hospital Services (e.g., Hospital Stay)40% Coinsurance after deductible
Skilled Nursing Facility40% Coinsurance after deductible
Substance Abuse Disorder Outpatient Services40% Coinsurance after deductible
Substance Abuse Disorder Inpatient Services40% Coinsurance after deductible
Maternity CareBronze 60 HDHP PPO
Delivery and All Inpatient Services for Maternity Care40% Coinsurance after deductible
Prenatal and Postnatal CareNo Charge
Other ServicesBronze 60 HDHP PPO
Mental/Behavioral Health Inpatient Services40% Coinsurance after deductible
Durable Medical Equipment40% Coinsurance after deductible
Hospice ServicesNo Charge
Bariatric Surgery40% Coinsurance after deductible
Mental/Behavioral Health Outpatient Services40% Coinsurance after deductible
Acupuncture40% Coinsurance after deductible
Rehabilitative Speech Therapy40% Coinsurance after deductible
Rehabilitative Occupational and Rehabilitative Physical Therapy40% Coinsurance after deductible
Abortion for Which Public Funding is Prohibited40% Coinsurance after deductible
Allergy Testing40% Coinsurance after deductible
Chemotherapy40% Coinsurance after deductible
Diabetes Education40% Coinsurance after deductible
Dialysis40% Coinsurance after deductible
Infusion Therapy30% Coinsurance after deductible
Prosthetic Devices40% Coinsurance after deductible
Radiation40% Coinsurance after deductible
Reconstructive Surgery40% Coinsurance after deductible
Transplant40% Coinsurance after deductible
Treatment for Temporomandibular Joint Disorders40% Coinsurance after deductible
Outpatient ServicesBronze 60 HDHP PPO
Outpatient Surgery Physician/Surgical Services30% Coinsurance after deductible
Outpatient Facility Fee (e.g., Ambulatory Surgery Center)40% Coinsurance after deductible
Outpatient Rehabilitation Services40% Coinsurance after deductible
Prescription Drug CoverageBronze 60 HDHP PPO
Tier 1 Drugs40% up to $500/ prescription
Tier 2 Drugs40% up to $500/ prescription
Tier 3 Drugs40% up to $500/ prescription
Tier 4 Drugs (Excluding Specialty Drugs) 40% up to $500/ prescription
Preventative CareBronze 60 HDHP PPO
Well Baby Visits and CareNo Charge
Preventive Care/Screening/ImmunizationNo Charge
Professional ServicesBronze 60 HDHP PPO
Other Practitioner Office Visit (Nurse, Physician Assistant)40% Coinsurance after deductible
Imaging (CT/PET Scans, MRIs)40% Coinsurance after deductible
X-rays and Diagnostic Imaging40% Coinsurance after deductible
Specialist Visit40% Coinsurance after deductible
Laboratory Outpatient and Professional Services 40% Coinsurance after deductible
Primary Care Visit to Treat an Injury or Illness 40% Coinsurance after deductible

Benefits stated above are using in network preferred providers only. Click here for provider information.

Information contained in this website is limited in scope, subject to change without notice, and does not contain all the terms, conditions, limitations, or exclusions of the referenced benefit plans. Only the insurance company Plan Documents and Policy's contain the exact terms and conditions of coverage.

 

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