
Blue Shield Bronze 60 PPO
This plan are for those who are looking to comply with the individual mandate of the Affordable Care Act.
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. 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 Name | Bronze 60 HDHP PPO |
Combined Medical & Drug Deductible | Individual: $4,800 Family: $9,600 |
Annual Out-of-Pocket | Bronze 60 HDHP PPO |
Out of Pocket Max for Med and Drug EHB Benefits (Total) | Individual: $6,550 Family: $13,100 |
Emergency Health | Bronze 60 HDHP PPO |
Urgent Care Centers or Facilities | 40% Coinsurance after deductible |
Emergency Room Services | 40% Coinsurance after deductible |
Emergency Transportation/Ambulance | 40% Coinsurance after deductible |
Home Health Care | Bronze 60 HDHP PPO |
Home Health Care Services | 40% Coinsurance after deductible |
Hospitalization Services | Bronze 60 HDHP PPO |
Inpatient Physician and Surgical Services | 40% Coinsurance after deductible |
Habilitation Services | 40% Coinsurance after deductible |
Inpatient Hospital Services (e.g., Hospital Stay) | 40% Coinsurance after deductible |
Skilled Nursing Facility | 40% Coinsurance after deductible |
Substance Abuse Disorder Outpatient Services | 40% Coinsurance after deductible |
Substance Abuse Disorder Inpatient Services | 40% Coinsurance after deductible |
Maternity Care | Bronze 60 HDHP PPO |
Delivery and All Inpatient Services for Maternity Care | 40% Coinsurance after deductible |
Prenatal and Postnatal Care | No Charge |
Other Services | Bronze 60 HDHP PPO |
Mental/Behavioral Health Inpatient Services | 40% Coinsurance after deductible |
Durable Medical Equipment | 40% Coinsurance after deductible |
Hospice Services | No Charge |
Bariatric Surgery | 40% Coinsurance after deductible |
Mental/Behavioral Health Outpatient Services | 40% Coinsurance after deductible |
Acupuncture | 40% Coinsurance after deductible |
Rehabilitative Speech Therapy | 40% Coinsurance after deductible |
Rehabilitative Occupational and Rehabilitative Physical Therapy | 40% Coinsurance after deductible |
Abortion for Which Public Funding is Prohibited | 40% Coinsurance after deductible |
Allergy Testing | 40% Coinsurance after deductible |
Chemotherapy | 40% Coinsurance after deductible |
Diabetes Education | 40% Coinsurance after deductible |
Dialysis | 40% Coinsurance after deductible |
Infusion Therapy | 30% Coinsurance after deductible |
Prosthetic Devices | 40% Coinsurance after deductible |
Radiation | 40% Coinsurance after deductible |
Reconstructive Surgery | 40% Coinsurance after deductible |
Transplant | 40% Coinsurance after deductible |
Treatment for Temporomandibular Joint Disorders | 40% Coinsurance after deductible |
Outpatient Services | Bronze 60 HDHP PPO |
Outpatient Surgery Physician/Surgical Services | 30% Coinsurance after deductible |
Outpatient Facility Fee (e.g., Ambulatory Surgery Center) | 40% Coinsurance after deductible |
Outpatient Rehabilitation Services | 40% Coinsurance after deductible |
Prescription Drug Coverage | Bronze 60 HDHP PPO |
Tier 1 Drugs | 40% up to $500/ prescription |
Tier 2 Drugs | 40% up to $500/ prescription |
Tier 3 Drugs | 40% up to $500/ prescription |
Tier 4 Drugs (Excluding Specialty Drugs) | 40% up to $500/ prescription |
Preventative Care | Bronze 60 HDHP PPO |
Well Baby Visits and Care | No Charge |
Preventive Care/Screening/Immunization | No Charge |
Professional Services | Bronze 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 Imaging | 40% Coinsurance after deductible |
Specialist Visit | 40% 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.