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Blue Cross of California
PPO Share 1500 Plan
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PPO Share Health Plan BrochureBlue Cross of California and BC Life & Health Insurance Company

Quick Quoteoffer several health insurance plans to choose from for individuals and families. The Blue Cross of California PPO Share 500 Plan covers the same comprehensive package of health care services that all of the PPO Share Plans do. The difference is in the deductible, the coinsurance amount and annual out-of-pocket maximums. Blue Cross of California offers a variety of PPO Share Plans to choose from offering just the right balance between cost and benefits. Featuring prescription drug coverage, maternity benefits, doctors' office visits, hospitalization, professional services, emergency services and preventive care make the PPO Share 500 a popular choice.

Consider one of the PPO Share plans if you are planning to have children or are already raising a family - they can also work well if you're on your own. You have the fexibility to choose from five levels of medical deductibles, and after meeting that deductible, you'll pay just 30% of the negotieated fee for most covered services.

How to Enroll

Dental BlueEnrolling 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
  • Monthly RatesA 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

 
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PPO Share 500 Benefit Matrix
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Benefit In-Network Out-of-Network
Annual Deductible $500 Per member
(Once 2 members each reach the deductible,
the deductible is satisfied for the entire family.)
Lifetime Maximum $5,000,000
Annual Out-of-Pocket Maximum
(includes deductible)
Participating & non-participating provider covered services combined		 $5,000 per member
(Once 2 members each reach the maximum, the maximum is satisfired for the entire family)
Doctors' Office Visits 30% of negotiated fee
(deductible waived) 		50% of negotiated fee plus excess charges
(deductible waived )
Professional Services
(X-ray, lab, anesthesia, surgeon, etc.) 		30% of negotiated fee 50% of negotiated fee plus excess charges
Hospital Inpatient
(Overnight Hospital Stays)		 30% of negotiated fee2 All Charges except $650 per day
Hospital Inpatient
(If You Don't Stay Overnight)		 30% of negotiated fee2 All Charges except $380 per day
Emergency Room Services 30% of negotiated fee 30% of customary and reasonable fees plus excess charges
Maternity 30% of negotiated fee 50% of negotiated fee plus excess charges
Preventive Care

Annual physical exam(s): 30% of negotiated fee*
(deductible waived)
or
HealthyCheckSM Centers5: $25/$75 copay for basic/premium screening (deductible waived)

Routine mmamogram, Pap and PSA tests4: 30% of negotiated fee (deductible waived)

Well Baby and Well Child (through age 6): 40% of negotiated fee (deductible waived)

Annual phyical exam(s): 50% of negotiated fee* plus all exess charges (deductible waived)

Routine mammogram, Pap and PSA tests4: 50% of negotiated fee plus all excess charges (deductible waived)

Well Baby and Well Child (through age 6): 50% of negotieated fee plus all excess charges (deductible waived)

Ambulance 30% of negotiated fee 50% of negotiated fee plus excess charges
Physical & Occupational Therapy; Chiropractic Services 30% of negotiated fee All charges except $25 per visit, up to 12 visits per year6
Accupunture/Accupressure All Charges except $25 per visit, up to 24 visits per year (deductible waived)
Prescription Drugs
(Blue Cross Formulary7)
Amounts shown are for each 30-day retail or in-network mail order supply 		$10 copay genric; $30 copay brand-name8 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 $250 brand-name prescription drug deductible.
Other Blue Cross PPO Share Plan Links
P O Box 6374 Jackson, WY 83002-6374

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