Essential Plans
1750, 3000 & 4500 Blue Shield of California Life & Health Insurance Co.
Blue Shield of California provides three Essential choices.....
Blue Shield of California provides three choices to the consumer with ESSENTIALSM PLAN 1750, 3000 AND 4500. These low-cost individual plans minimize you annual out-of-pocket costs and offer the broad range of quality coverage you need. These PPO plans for individuals are among their lowest cost options, and make getting the coverage you need simple by combining medical, dental and vision all in one plan.
Plan Highlights
First-dollar coverage for three physician visits annually before meeting deductibles.
Dental benefits include diagnostic and preventive services
Annual vision examination
Predictable copayments for doctor visits, dental, and vision services
After the deductible is met, all network medical services are covered 100 percent, including x-rau and lab services
Generic prescriptions are covered with a low copayment (this plan doesn't include brand-name drugs)
Access to one of California's largest networks with more than 48,000 providers and 350 hospitals statewide
Another advantage of the Essential Plan benefits is that you will enjoy discounts for LASIK surgery. LASIK surgery, an alternative to contacts or glasses, is one of the fastest growing vision treatments. Essentail Plan members have access to a 15 percent LASIK surgery discount through the TLCVision Provider Network.**
Is an Essential Plan right for you?
You know you need coverage for predictable and unpredictable events, but you don't want to spend a lot on monthly rates. EssentialSM Plan 1750, 3000 and 4500 provide the affordable quality coverage you need and limit your possible out-of-pocket costs. The plans are available for individuals only and do not provide maternity or brand-name drug benefits. With a Blue Shield of California Essential Plans 1750, 3000 and 4500 you'll enjoy access to one of the largest provider networks in California.
Another strong benefit is that if you become pregnant as a member on an Essential plan, Blue Shield of California Life & Health offers a free transfer to their Shield Spectrum PPO Plan 5000.
Blue Shield of California's
Essential Plan Advantages
Affordable monthly rates
Affordable Monthly Rates
Copayment maximum equals the deductible
You're covered a 100 percent after the deductible is met
Affordable copayments for preventive care office visits ($40) and generic prescription drugs at network pharmacies ($10)
Comprehensive coverage - includes medical, dental and vision care
LASIK discount program*
Choice of three deductibles ($1,750, $3,000 and $4,500)
No Maternity coverage, however, members who become pregnant can transfer without underwriting into the Shield Spectrum PPO Plan 5000.
Access to one of California's largest PPO provider networks in California
Knowledgeable customer service representatives who can assist you and quickly answer your questions
**This discount program is not part of the Essential Plan and is offered in addition to the benefits covered under the Essential plans. Members who are not satisfied with services received under the discount program may use the Blue Shield Life grievance process. Blue Shield reserves the right to terminate this program without notice.
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)
Sales Assistance
Blue Shield of California Essential Plans at a Glance These plans are underwritten by Blue Shield of California Life & Health Insurance Company.
ESSENTIAL PLAN 1750, 3000 AND 4500 Monthly Rates
Plan Options
Essential Plan 1750
Essential Plan 3000
Essential Plan 4500
DEDUCTIBLE
$1,750
$3,000
$4,500
COPAYMENTS
$40 with Preferred Providers Not applicable with Non-Preferred Providers
$40 with Preferred Providers Not applicable with Non-Preferred Providers
$40 with Preferred Providers Not applicable with Non-Preferred Providers
CALENDAR YEAR COPAYMENT/ COINSURANCE MAX (Includes plan deductible, some services do not apply)
Services with Preferred Providers: $1,750
Individual only Services with All Providers: $3,500
Services with Preferred Providers: $3,000
Individual only Services with All Providers: $5,000
Services with Preferred Providers: $4,500
Individual only Services with All Providers: $6,500
