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Blue Cross Of California’s $30 Co Pay PPO Option |
For constituents of Blue Cross of California who wish to exercise a little more freedom with their health care choices, the $30 co pay Preferred Provider Organization plan option. Blue Cross’s PPO options cover up to $5 million in lifetime benefits, and there are no deductibles for doctor’s office visits or for prescription drugs, with a $500 dollar annual deductible.
The Out of Pocket maximum, the total amount constituents are subject to pay out of their pocketbooks toward the cost of their health care, is $4000 for in network expenses, and $10,000 for out-of-network health care expenses under the $30 co pay PPO option. This maximum out of pocket amount is applicable toward the two allowed members on the $30 co pay PPO plan.
Blue Cross members are required to pay $30 co pay up front for medical services rendered during a routine doctor’s office visits; first twelve visits per year are allowed under this option, and 45 percent of medical expenses incurred for every visit after the twelve yearly visit quota has been satisfied. Also, 70 percent of the cost of hospital visits is covered under the $30 co pay PPO option.
After the $150 name brand drug deductible has been satisfied, members are required to pay a $25 co pay for their name brand prescription drugs and a $15 deductible for generic drugs. Excluding inject able insulin, Blue Cross of California will even pay up to 70 percent of the member’s expense for covered self-administered drugs given by injection.
Blue Cross members are required to pay $25 to $75 dollars toward an annual HealthyCheck screening if they choose to exercise this option--the exact fee depends on the level of service the member has selected with their plan. As with the $40 co pay option, physical exams are not covered expenses for this PPO option. Blue Cross of California will also pay 50 percent of the cost of other professional medical services, such as maternity exams, x-rays and other included lab work. The member is responsible for payment of excess charges related to covered professional services as well.
Another unique feature of Blue Cross of California’s $30 co pay PPO option is that preventative care is a covered medical expense. Preventative care is care that is taken before an illness is contracted, such as Well Baby check ups, mammograms, and prostate exams. The only cost to the member for preventative services is the $30 co pay, as well as 30 percent of the cost of other charges incurred during preventative exams.
Learn more at: www.baahealth.com
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