|
 |
|
Blue Shield of California
Access+ HMO Health Insurance Plan |
|
|
| |
|
 Do you or your dependents go to the doctor often?
 If your answer is "yes" Access+ HMO might be the right plan for you: You'll have access to a wide range of routine and preventive care services, prescription drug coverage and mental healthcare visits for a small copayment or for no out-of-pocket charge at all, without having to meet a deductible.
Please see the following Uniform Plan Matrix for specific benefit details.
Blue Shield of California Access+ HMO plan advantages
- $20/$35 office visit copayments; $10 copayments for generic drug prescriptions
- Access to a speicalist without a referral in your Personal Physician's participating medical group/IPA for a $35/$50 copayment
- Preventive Care provided at no extra charge
- Blue Shield's HMO network has more than 25,000 doctors and 280 hospitals thoughout California
- Basic dental services with Access+ HMO
- No lifetime maximum on plan benefits
- Virtually no claim forms
Personal Care from your Personal Physician
Your relationship with the Personal Physician you choose is the key to your Access+ HMO Plan. He or she will:
- Provide or coordinate your necessary medical services
- Arrange for referrals to specialists and hospitals and other covered non-physician healthcare practitioners
- Authorize medically necessary Emergency Services. (Your Personal Physician or his or her designee will be available 24 hours a day, seven days a week.)
Other Links
|
| Special Features of the Access+ HMO Plan
Self-Referral to Specialist
With Access+ Specialist you can go directly to a specialist or other physician in the same medical group or IPA as your Personal Physician, without a referral. When you self-refer, your copayment will be $35/$50 per covered office visit (depending on which plan option you select). To use the Access+ Specialist option, you must belong to a medical group or IPA that is an Access+ Specialist provider group.
Self-referrals to Gynecological Exams and OB/GYN Visits
Women may go to directly to an OB/GYN or family preactice physician in the same medical group or IPA as their Personal Physician for obstetrical/gynecological services - including annual gynecological exams - without a referral.
Money-back Guarantee
Blue Shield's member feedback program, Access+ Satisfaction, will refund your usual office visit copayment and provide a postage-paid postcard for your comments if you are ever dissatisfied with the service you receive during a covered office visit with an HMO network physician. |
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)
|
|
|
Blue Shield of California Access+ HMO Plans
|
Access+ Value HMO |
Access+ HMO |
| DEDUCTIBLE* |
$2,000 ($4,000 Family) |
$2,000 ($4,000 Family) |
|
CALENDAR YEAR OUT-OF-POCKET MAXIMUM
The calendar year copayment maximum includes the plan deductible (Certain copayments do not apply twards the out-of-pocket maximum - refer to brochure)
|
$4,000 ($8,000 family) |
$3,000 ($6,000 Family) |
| LIFETIME MAXIMUMS |
No Limit |
No Limit |
|
|
|
|
| P O Box 6374 Jackson Hole, WY 83002-6374 |
Home Page || Blue Cross of California || Blue Shield of California || Blue Cross Blue Shield of AZ || Anthem Blue Cross Blue Shield
International Medical Plans || Short Term Plans || SOUND || Tonik Health Plans || UniCare || Enrollment Packet, || For Agents Only
Copyright© 2003-2007 by Teton Marketing Technologies LLC, Timothy N Jennings, All Rights Reserved |
 |
|
 |
|
