Blue Shield of California Shield Spectrum PPO Savings Plans
These are Blue Shield of California's HSA Compatible PPO plans. You may combine these plans with a Health Savings Account and deposit the plan deductible into a tax-deferred bank account from which you can make withdrawals for qualified medical care and not pay a penalty. There are 4 plans to choose from, two are available to individuals and the other two are for subscriber and spouse or families. The Spectrum PPO Savings plans available to individuals are the 2400 and the 4000 plan. Families must enroll in either the 4800 or the 8000 Spectrum PPO Savings Plans. With all plans, your out-of-pocket maximum includes your selected plan deductible, so your total share for medical expenses will not exceed the calendar year out-of-pocket maximum. Office visits for preventive care, including a routine physical exam, OB/GYN exam or well-baby care visits are $35 and not subject to the plan deductible. Pap tests and mammograms, if part of an annual prevention exam, are a 30% coinsurance, but also not subjected to the deductible. On all of the Shield Spectrum PPO Savings Plans offer limited chiropractic care in which Blue Shield will pay for up to 12 visits per year. When using non-preferred providers, benefits are reduced to 50% of the allowable amount and the coinsurance maximums are increased.
Blue Shield of California Shield Spectrum PPO Savings 2400/4800 Plans
The PPO Savings 2400 plan is only available to individuals. With more than one family member on the plan, you must enroll in the PPO Savings 4800 Plan. These offer the lowest deductibles and require a slightly higher monthly premium. On the 2400 Plan, the coinsurance maximum is $3,200 and it is $5,800 on the 4800 Plan. Once the plan deductible has been met, there is a 30% coinsurance for most covered services, but only up to the coinsurance maximum, which includes the plan deductible. This applies to even prescription drug coverage, which are available at no additional cost once you reach the plan maximum. Emergency room visits require an additional $75 copayment, for which you will continue to be responsible, even if you reach your coinsurance maximum. Of the two Spectrum PPO Savings Plans, this is the only one that provides maternity coverage, which includes prenatal, postnatal, delivery and inpatient hospital services.
Blue Shield of California Shield Spectrum PPO Savings 4000/8000 Plans
The Savings 4000 Plan is available to individuals, and the 8000 Plan is for more than one subscriber on the same health insurance policy. The deductible is higher than the other Spectrum PPO Savings Plans, but once you meet these deductibles, there is no coinsurance required and you are covered in full for the remainder of the calendar year. The deductible on the individual plan is $4,000 and the multi-subscriber Savings 8000 Plan has a family deductible of $8,000. The family deductible is accumulative and there is no separate individual deductible that applies. If only one family member contributes to the deductible with needed medical care, that individual family member must meet the $8,000 deductible. However, once they do, all other family members will have met their deductibles as well. The 4000 and 8000 Spectrum PPO Savings plans do not provide maternity benefits.
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.