Blue Cross of California PPO Share Plans

Of the many different types of PPO plans offered by Blue Cross of California, their PPO Share plans are the most comprehensive. The highest deductible Share Plan, the PPO Share 5000, is offered through BC Life & Health Insurance Company. There are five different deductible options to choose from, the lowest being $500 with the highest deductible at $5,000. The PPO Share plans offer out-of-state coverage, access to a large provider network, no deductible for preventative care and the freedom to choose your own doctors within the network. For those planning a family, all of the PPO Share plans provide maternity benefits.

Blue Cross PPO Share 500 Plan

This is the lowest deductible PPO Share plan, offering a low annual deductible of $500. The deductible does not apply to office visits, which are unlimited with a 30% co-payment. Out-of-network office visits are available at 50% of the negotiated fee, plus any excess charges. The maximum annual out-of-pocket limit to you is $5,000. You have immediate (deductible-free) benefits for office visits and generic drugs. All other covered services have a 30% coinsurance until you have meet your annual coinsurance maximum. For non-preferred participating hospitals, there is an additional admission fee of $500.

Blue Cross PPO Share 1000 Plan

The PPO Share 1000 Plan has an annual deductible of $1,000. Office visits and prescription drugs do not apply to the annual deductible. There is a separate deductible of $250 that applies to brand name drugs only. Generic drugs are provided with no deductible and a copay of only $10. Professional services, hospitalization and outpatient surgery requires a 30% coinsurance until you have met the maximum annual out-of-pocket limit of $5,000. Emergency room visits are covered with separate $100 copay, which is waived if you are admitted into the hospital.

Blue Cross PPO Share 1500 Plan

The PPO Share 1500 Plan has an annual deductible of $1,500. This deductible applies to all covered services except office visits and prescription drugs. Hospital coverage is determined by two classes of participating providers, preferred hospitals and participating hospitals. When using a preferred hospital, there are no additional admission charges. Out-of-network hospital charges are limited to a maximum benefit of $650 per day. Outpatient surgical procedures outside of the provider network are limited to $380 per day.

Blue Cross PPO Share 2500 Plan

The PPO Share 2500 plan offers in-hospital benefits and coverage for other professional services, after you met the annual deductible of $2,500. The deductible does not apply to office visits, which have a 30%coinsurance. The maximum annual out-of-pocket maximum to you is $7,500, which includes the plan deductible. Prescription drugs are covered at $10 generic and $30 brand with a $500 annual deductible that applies to brand name drugs only. Some preventive care is not subject to the plan deductible, including mammograms, Pap and PSA test, well baby and well child care.

BC Life & Health PPO Share 5000 Plan

The PPO Share 5000 plan is the highest deductible plan of the five and is the only one offered through BC Life & Health. The deductible does not apply to office visits, which are a covered at a 30% coinsurance. The maximum annual out-of-pocket maximum to you is $7,500. Prescription drugs are covered at $10 for generic and $35 for brand (Brand drugs have an annual deductible of $750). Maternity benefits are provided at 30% of the negotiated fee when using in-network providers. An additional $500 hospital admission fee will apply if you use a non-preferred hospital within the network.

The information provided on this page is subject to change and my not be current. Check with the insurance company or your insurance agent for verification of details. The information provided is for comparison purposes only and is not legally binding. Always review the plan brochure or your policy details for complete and accurate details about this policy.