Blue Shield Wise PPO Plans

These plans offer dependable coverage, affordability and choice.

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

These plans offer dependable coverage, affordability and choice. They offer 3 deductible options that include 3 different coinsurance percentages to tailor your specific needs. These plans limit the number of office visits per calendar year (additional visits subject to the annual deductible) which helps keep premiums affordable. These plans include no charge annual physical exams. They are for those seeking comprehensive coverage that include both brand and generic prescription drugs. The plans also include hospitalization, ambulance, laboratory (blood and urine tests) and x-rays, Blue Shield of Californiachiropractic and acupuncture coverage, maternity, home health, mental health, and physical therapy benefits all subject to the coinsurance percentage and some limitations after the annual deductible, up to the out of pocket maximum. Since the out of pocket maximum includes the annual deductible, you will know the maximum amount you could be responsible for if something catastrophic were to happen. Plan highlights are:

  • $25, $35, or $45 per office visit copayments depending upon the plan you choose (limited to 2 visits per calendar year)

  • $10 generic drugs

  • $35 brand formulary drugs (after a $3,000 annual brand drug deductible)

  • $60 or 50% (whichever is greater) for non-formulary brand drugs (after a $3,000 annual brand drug deductible). $150 maximum per prescription

  • $2,500, $3,500, or $4,500 deductible options

  • $7,500, $8,500, or $9,500 out of pocket maximums (includes the medical annual deductible)

  • 25%, 35%, or 45% coinsurance depending on plan you choose

  • $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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