Shield Spectrum PPO - California (Effective 07/01/2012)
Health Insurance Plans for Individuals and Families

These 2 plans are some of the lowest priced plans offered by Blue Shield. They are a comprehensive high deductible health plan with office visits per calendar year and no charge for annual physical exams. Generic and Brand Drug coverage is provided. The plans also include, hospitalization, ambulance, laboratory (blood and urine tests) and x-rays, chiropractic and acupuncture coverage, maternity, home health, mental health, and physical therapy benefits all subject to a coinsurance percentage after the annual deductible, up to the out of pocket maximum. The out of pocket maximum includes the annual deductible. This is very important to know because in a catastrophic situation, you would want to know the maximum amount you could be responsible for. Plan highlights are:

  • $35 office visit copayment after the annual deductible or 35% coinsurance after the annual deductible     depending upon the plan

  • $10 generic formulary drugs

  • $35 or $45 brand formulary drugs (after a $500 annual brand drug deductible) depending upon the     plan

  • $50 or 50% or $60 or 50% (whichever is greater) for non-formulary brand drugs (after a $500 or $750     annual brand drug deductible) depending upon plan

  • $5,000 deductible or $5,500 deductible depending upon the plan

  • $7,000 or $7,500 out of pocket maximum depending upon the plan (includes the medical annual     deductible)

  • 30% or 35% coinsurance depending upon the plan

  • $0 preventive care services (routine annual physical exams)

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

If you need assistance with individual and family plan options and enrollment, call us today at
(800)560-2443.

 

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