PacifiCare of California SignatureFreedom SDHP Plans 

PacifiCare offers two SDHP plans to individuals in California under the SignatureFreedom category. These self-directed health plans are ideal choices for healthy individuals that believe in managing their own health care needs. When you enroll in a PacifiCare SignatureFreedom plan, you have access to a self directed account balance that can be used for office visits, preventive health care and lab and radiology. This self-directed account (SDA) gives you first dollar coverage for the applicable medical services that you select. Even though these services are covered in full, the amount that you access from your SDA is applied to the calendar year deductible. The amount available in the SDA is calculated on a quarterly basis and any unused balance is carried over to the following quarter. Year-end SDA balances are not carried over to the following year. Regardless of which PacifiCare SDHP plan you select, there is a $250 per quarter allowance in the SDA account, and family plans are given $500 per quarter. This allows for $1,000 per year in "free" heath care for individuals and $2,000 for families. Hospitalization, outpatient surgery, emergency room visits and nontraditional medical expenses do not apply to the SDA benefits and will require you to meet the plan deductible and then pay a coinsurance. Neither SDHP plan provides maternity coverage. Both plans have the same prescription drug benefits; $20 generic and $35 brand after a $750 annual deductible that applies only to brand name drugs. Both plans have a $5 million lifetime maximum benefit amount, a 30% coinsurance, and a $4,000 coinsurance maximum that does not include the plan deductible.

PacifiCare of California SignatureFreedom SDHP 70-50/3000

This plan has the lower of the two deductible options at $3,000. This deductible is per insured member and the two-member family maximum found under some PacifiCare PPO plans does not apply. Office visits and wellness benefits can be paid for from the SDA. If the balance has been depleted from the SDA, you must meet your plan deductible and pay the coinsurance for these, and all other covered benefits on the plan.

PacifiCare of California SignatureFreedom SDHP 70-50/5000

Coverage under this plan is identical to the 70-50/3000 plan, except the deductible is higher at $5,000. Services covered under the Network Wellness Benefit include preventive care office visit fees, immunizations, x-ray and lab tests, mammograms, Pap Smears and prostate screenings. There is a $200 additional deductible for emergency room visits.

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.