Blue Cross of California Basic PPO Plans
Blue Cross of California, along with BC Life & Health, offer a large selection of PPO plans to meet the needs of all types of Californians. From their comprehensive PPO Share plans to their innovative Tonik Plans, Blue Cross has a PPO plan to fit the budget and benefit requirements of just about everybody. PPO plans provide members the freedom to choose their own physicians and self-refer themselves to specialists. Blue Cross of California has one of the largest networks of participating PPO physicians in the state of California. Members of a Blue Cross PPO plan also have access to physicians in other states while they are traveling for business or pleasure. Below is a summary of the four basic PPO plans available through BC Life & Health Insurance Company.
Blue Cross Basic PPO 1000
The Basic PPO 1000 plan is designed to protect you from catastrophic financial loss in the event of a major illness or injury. It pays for hospital expenses with a co-payment of 20% after you have met the $1,000 annual deductible. There are no prescription benefits with this plan and office visits are covered only after you have met the $3,500 maximum annual out-of-pocket limit. Some preventive care benefits are provided at a 20% co-insurance without having to meet your annual deductible. These include routine mammogram, Pap and PSA tests. Annual routine check-ups are available through HealthyCheck centers for an additional co-payment of $25 or $75, depending on the level of health screening you request. The Basic PPO 1000 plan has a lifetime maximum benefit of $5,000,000.
Blue Cross Basic PPO 2500
This plan is similar to the Basic 1000 plan, but the deductible is higher at $2,500. It is also a major medical, or catastrophic, health plan that is designed to protect you financially in the event of serious illness and injury. It pays for hospital expenses with your coinsurance only at 20% after you have met the $2,500 annual deductible. There is a two member maximum on meeting the annual deductible, so once two family members have reached this deductible, all remaining family members do not need to pay more toward this deductible. There are no prescription benefits with this plan and office visits are covered only after you have met the $5,000 maximum annual out-of-pocket maximum. Out-of-network hospitalization is limited to a maximum benefit of $650 per day. Preventative care under this plan is the same as that offered on the Basic 1000 plan.
Blue Cross PPO Saver Plan
The PPO Saver plan is the only Blue Cross basic plan that offers prescription drug coverage. There is a $500 annual hospital deductible and a $5,000 deductible for all other covered services. No deductible applies for office visits and you are allowed two office visits annually for a $30 co-payment. Children are allowed four annual office visits. The maximum annual out-of-pocket limit to you is $5,000 per member, with a two member family maximum. Some preventive care benefits are provided at a 20% co-insurance without having to meet your annual deductible. Prescription drug coverage is available with initiations. There is a $500 annual deductible for brand name drugs, after which you have a $30 copay. Generic drugs are provided for a $10 copay with no annual deductible. Unlike the other 2 basic plans, the PPO Saver plan provides a $25 benefit toward acupuncture and acupressure treatments.
Blue Cross RightPlan PPO 40
The RightPlan PPO 40 is designed for the single, healthy adult. In fact, it's only available to single adults. This is a no-deductible PPO plan, with a 40% coinsurance for in-network services. The annual out-of-pocket maximum is $7,500 with a lifetime maximum benefit of $5,000,000. There is a $500 per day hospital co-pay, for a maximum of 4 days. There are 3 different RightPlan options: 1) no Prescription Drug Option, 2) Generic Prescription Only Drug Option, and 3) Full Prescription Drug Option. Both plans that offer prescription benefits provide generic drugs for a $10 copay. The comprehensive RightPlan 40 provides brand name drugs for $30, after you have met the annual deductible of $500 that applies.
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.