Blue Cross of California
HMO Saver & Individual HMO Plan
Select HMO, HMO Saver and Individual HMO Plans
Blue Cross of California's HMO could be the right choice if you want to simplify decision-making, get valuable benefits and pay predictable out-of-pocket costs. Blue Cross of California offers three HMO Choices to choose from. If you find that your doctor doesn't participate in the Select HMO Network you may want to search the HMO Saver or Individual HMO Plan networks.
Which HMO Plan is for you?
Select HMO Plan
Exclusive network of doctors and hospitals in 22 California counties
Comprehensive HMO Coverage with lower monthly premiums
Immediate, no deductible benefits
Maternity Benefits
HMO Saver Plan
Comprehensive HMO coverage
$1,500 medical deductible for hospital and emergency services helps keep monthly premiums lower
Brand-name and generic prescription drug coverage
Maternity benefits
Individual HMO Plan
Comprehensive HMO coverage
Immediate no-deductible benefits
Brand-name and generic prescription drug coverage
Maternity benefits
How to Enroll
Enrolling is easy. Submit your application online by clicking the "APPLY NOW" link below. If you have questions and would like an agent to contact you prior to applying then give me a call.
To enroll, you must be:
Age 64 3/4 or younger
A permanent legal resident of California
A U.S. resident for at least the lst 3 months
The applicant's spouse or domestic partner, age 64 3/4 or younger
The applicant's children (under 19 years of age), or the children (under 19 years of age) of the applicant's enrolling spouse or qualified partner or qualified domestic partner;
The applicant's unmarried dependent children between the ages of 19 through 22 ("dependent" as defined by the Internal Revenue Service
$1,500 per member: Inpatient/Outpatient Hospital Services and Ambulatory Surgical Centers
$0
Lifetime Maximum
Unlimited
Annual Out-of-Pocket Maximum
$3,000 per member: Once two members each reach the maximum, the maximum is satisfied for the entire family (includes deductible)
$3,000 per member: Once two members each reach the maximum, the maximum is satisfied for the entire family
Doctors' Office Visits
$10 copay per visit
Professional Services (X-ray, lab, anesthesia, surgeon, etc.)
No Charge for office visit-related services
No Charge for office visit-related services
Hospital Inpatient (Overnight Hospital Stays)
20% of negotiated fee (after deductible)
20% of negotiated fee
Hospital Outpatient (If You Don't Stay Overnight)
20% of negotiated fee (emergency and non-emergency services are subject to the deductible)
20% of negotiated fee
Emergency Room Services
20% of negotiated fee (after deductible)
20% of negotiated fee
Maternity
Office visits:$10 copay Inpatient/Outpatient: After deductible, 20% of negotiated fee
Office visits:$10 copay Inpatient/Outpatient: 20% of negotiated fee
Preventive Care
$10 Copay for specific health maintenance services
$10 Copay for specific health maintenance services
Ambulance
$50 Copay waived if admitted to hospital
$50 Copay waived if admitted to hospital
Physical & Occupational Therapy; Chiropractic Services (up to 60 consecutive days following an illness or injury)
Outpatient: $10 Copay per visit
Inpatient: 20% of negotiated fee
Chiropractic services provided with medical group referral only
Accupunture/Accupressure
Not Covered
Prescription Drugs (Blue Cross Formulary) Amounts shown are for each 30-day retail or in-network mail order supply
$10 copay generic; $30 copay brand-name after $250 brand-name prescription drug deductible (2-member maximum); 30% of negotiated fee for self administered injectables, except insulin
50% of drug limited fee schedule and all excess charges plus the copay / coinsurance as stated for in-network benfits; subject to the annual $500 brand-name prescription drug deductible.
