Blue Shield Silver 70 PPO

These plans are for those who are looking for comprehensive coverage that includes low office visit copayments.

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Blue Shield Silver 70 Off Exchange PPO - Effective 2018
Health Insurance Plans for Individuals and Families

These plans are for those who are looking for comprehensive coverage that includes low office visit copayments with an unlimited number of office visits per calendar year and no charge for annualBlue Shield of California physical exams. There is an individual calendar deductible of $2,500 and a family deductible of $5,000. All covered services contribute to the out-of-pocket maximum. Preventive care services, such as routine physical exams and mammogram screenings, are at no charge. This is one of the most popular Blue Shield plans in California and will satisfy your mandated individual health insurance requirement also known as "minimum essential health coverage ".

Plan Name Silver 70 PPO
Medical Deductible Individual: $2,500 Family: $5,000
Drug Benefits Deductible Individual: $130 Family: $260
Default Medical Coinsurance 20%
Default Drug Coinsurance 20%
Annual Out-of-PocketSilver 70 PPO
Out of Pocket Max for Med and Drug EHB Benefits (Total) Individual: $7,000 Family: $14,000
Emergency HealthSilver 70 PPO
Urgent Care Centers or Facilities $350/visit
Emergency Room Services $350/visit
Emergency Transportation/Ambulance $255 after deductible
Home Health CareSilver 70 PPO
Home Health Care Services $45/visit
Hospitalization ServicesSilver 70 PPO
Inpatient Physician and Surgical Services 20% after deductible
Habilitation Services $35/visit
Inpatient Hospital Services (e.g., Hospital Stay) 20% after deductible
Skilled Nursing Facility 20% after deductible
Substance Abuse Disorder Outpatient Services $35/visit
Substance Abuse Disorder Inpatient Services 20% after deductible
Maternity CareSilver 70 PPO
Delivery and All Inpatient Services for Maternity Care 20% after deductible
Prenatal and Postnatal CareNo Charge
Other ServicesSilver 70 PPO
Mental/Behavioral Health Inpatient Services 20% after deductible
Durable Medical Equipment 20%
Hospice ServicesNo Charge
Bariatric Surgery 20% after deductible
Mental/Behavioral Health Outpatient Services $35/visit
Acupuncture $35/visit
Rehabilitative Speech Therapy $35/visit
Rehabilitative Occupational and Rehabilitative Physical Therapy $35/visit
Abortion Services 20%
Allergy Testing Specialist Physican Visit 20%
Chemotherapy 20%
Diabetes self-management training at office $0
Dialysis 20%
Infusion Therapy 20%
Prosthetic Devices 20%
Radiation 20%
Reconstructive Surgery 20%
Transplant 20%
Treatment for Temporomandibular Joint Disorders 20%
Outpatient ServicesSilver 70 PPO
Outpatient Surgery Physician/Surgical Services 20%
Outpatient Facility Fee (e.g., Ambulatory Surgery Center) 20%
Outpatient Rehabilitation Services $35/visit
Prescription Drug CoverageSilver 70 PPO
Non-Preferred Brand Drugs See OEC for details
Preferred Brand Drugs See OEC for details
Specialty Drugs See OEC for details
Preventative CareSilver 70 PPO
Well Baby Visits and CareNo Charge
Preventive Care/Screening/ImmunizationNo Charge
Professional ServicesSilver 70 PPO
Other Practitioner Office Visit (Nurse, Physician Assistant) $35
Imaging (CT/PET Scans, MRIs) 20%
Outpatient X-rays and Diagnostic Imaging performed in a Hospital $75/visit
Specialist Visit $35
Outpatient Diagnostic Laboratory and Pathology Performed in a Hospital $75/visit
Outpatient radiology center $300/visit

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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