Blue Cross of California Blue Cross HMO Saver Plan Information
Plan Type: HMO
Physician Choice: General practitioner chooses specialist(s)
Annual Out-of-Pocket Maximum (includes deductible): $3000/member, 2 member maximum
Annual Deductible: $1500/member applies for inpatient hospital services, outpatient Ambulatory Surgical Centers.
Office Visits: $10 copay/visit
Professional Services: $10 copay/visit
Hospital Inpatient/Outpatient: $1500 deductible applies; Inpatient: 20% of negotiated fee; Outpatient: 20% of negotiated fee (emergency and non-emergency services are subject to the deductible)
Emergency Services: $1,500 deductible; $100 emergency room copay (waived if admitted) plus 20% of negotiated fee.
Maternity: Office visits, inpatient and outpatient paid as above (inpatient and outpatient subject to deductible)
Preventive Care - General: $10 copay for specific health maintenance services
Drug Benefits: $10 generic; $30 brand-name copay after $250 brand-name deductible; 30% of negotiated fee for self-administered injectables, except insulin
Financial/Tax Incentive: No
Specialty Pharmacy Drug Benefit: Certain drugs will be obtainable only through Precision Rx Specialty Solutions.
Other Blue Cross of California health insurance plans:
- BCL&H CORE 5000
- 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
- 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
