| |
Blue Cross of California’s $40 Co Pay PPO Option |
Blue Cross’s Preferred Provider Organization (PPO) option is an excellent option for constituents who receive medical attention throughout the year, and are satisfied with paying a little more out of pocket towards their health care expenses in order to bring the overall cost of the health care plan each month. PPO health care plans are the most favorable health care plan types for people who want or need a little more personal control over their health care and the professionals who provide it. These plans are called PREFERRED Provider Organizations for a reason; being in a PPO plan gives you the option to choose from a list of network providers, so you can feel comfortable that your health care is in the right hands.
The $40 co pay PPO plan option that is offered by Blue Cross of California offers a $40 co pay for twelve doctor’s office visits each year--so the constituent is covered up to approximately one visit to an in-network doctor’s office per year. After the twelve yearly office visit quota has been reached, the constituent would be responsible for 45 percent of the charges incurred for every doctor’s office visit after that, whether the provider is in-network or out-of-network. There is a $500 dollar per member annual deductible, which does not include the $40 doctor’s office visit co pay. This is limited to two members and it does apply towards the Out Of Pocket Maximum of $4500 per member for in network expenses and up to $10,000 dollars for out-of-network services.
If a constituent wishes to utilize the services of a non-included health care provider, they are immediately responsible for half of the service fees incurred and would be responsible for covering the full amount of any excess charges. Although sometimes unavoidable, not only is it preferred that Blue Cross constituents utilize in-network services, but in-network services are a lot less expensive out-of-pocket as well.
Blue Cross of California’s $40 co pay PPO option also offers preventative care, which also carries with it that $40 charge for an office visit. Preventative care includes Well Baby check ups as well as adult health screenings including pap smears, mammograms, and Prostate Specific Antigens for men. Not all other Blue Cross plans include Preventative Care--this is an option that is included in PPO plans.
Also covered by Blue Cross of California’s $40 co pay PPO option is a HealthyCheck health screening, with a co pay that ranges from $25 to $75 dollars, based on the level of care that is chosen by the patient. Annual physical exams are unfortunately not covered.
For prescription drugs, after the $150 member fee is satisfied, name brand drugs are subject to a $25 co pay and generic drugs are subject to a $15 co pay. For drugs that are self-injected (excluding insulin) Blue Cross of California will pay 70 percent of the cost, leaving 30 percent for the constituent to be responsible for.
Learn more at: www.baahealth.com
|
