Blue Cross of California BCL&H CORE 5000 Plan Information
Plan Type: PPO
Physician Choice: You choose specialist(s)
Annual Out-of-Pocket Maximum (includes deductible): $7500/member, 2 member maximum
Annual Deductible: $5000/member, 2 member maximum
Office Visits: Plan pays 100% after Out of Pocket reached.
Professional Services: 30% after deductible for inpatient or surgical related services.
Hospital Inpatient/Outpatient: 30% after deductible
Emergency Services: 30% after deductible; $100 ER copay, waived if admitted.
Maternity: Not covered
Preventive Care - General: 30% for mammogram, pap and PSA tests, $25 or $75 copay for basic or premium HealthlyCheck screening. Deductible waived.
Drug Benefits: Generic Rx only - $10 per 30 day supply, $20 per 60 day supply
Financial/Tax Incentive: No
Other Blue Cross of California health insurance plans:
- BCL&H Basic PPO 2500 with Life
- BCL&H Basic PPO 1000 with Life
- Individual PPO $3500 with HSA Compatibility
- Lumenos HSA 5000/10000/100
- Lumenos HIA 5000/10000/100
- BCL&H 3500 Deductible
- BCL&H RightPlan PPO 40 w/No Rx
- BCL&H RightPlan PPO 40 w/Generic Rx
- BCL&H PPO Share 5000
- Lumenos HIA Plus 5000/10000/100
- BCL&H RightPlan PPO 40 w/Rx
- BCL&H PPO Saver with Life
- Individual Select HMO
- Lumenos HSA 3000/6000/100
- Lumenos HIA 3000/6000/100
- Blue Cross PPO Share 2500
- Lumenos HSA 2500/5000/100
- Lumenos HIA 2500/5000/100
- Lumenos HIA Plus 3000/6000/100
- Blue Cross HMO Saver
- Lumenos HIA Plus 2500/5000/100
- Blue Cross PPO Share 1500
- Lumenos HSA 1500/3000/100
- Lumenos HIA 1500/3000/100
- BCL&H PPO Share 1000
- BCL&H PPO Share 500
- Blue Cross Individual HMO
