|
|
|
|
Blue Shield of California
Vital Shield Plus 900 Plan
(Underwritten by Blue Shield of California Life & Health Insurance Company)
 Blue Shield of California's lowest priced PPO Plan Series
 Is a Vital Shield Plus plan right for your? - Blue Shield of California now provides plan options that exceed the original plan design of their Vital Shield plans. Vital Shield Plus provides the same coverage as the Vital Shield plans PLUS a lower deductible option, PLUS brand or generic prescription drug options, PLUS lower office visits and preventive care copayments.
Vital Shield Plus plans offer you and your family the vital health coverage you need to protect yourself against the high costs of hospitalization, surgery, and other major medical events. And with NO maternity coverage and generic prescription drug coverage options, you aren't paying for services you don't expect to use.
Vital Shield Plus 900 advantages...
- Control your monthly rate by choosing a low deductible of $400, a moderate deductible of $900, or a higher deductible of $2,900
- 5 calendar year office visits for preventive care, before you have to meet the deductible, so you will get the care you need in case of injury
- Generic prescription drug coverage right away, before you have to meet a deductible, for only $10 at network pharmacies
- You are covered at 100% after you meet the coinsurance maximum, so you're protected when you need it most
- If you do not meet your annual medical deductible in a calendar year, you can "carry-over" the amount accrued, from October to December of that year, and apply it towards your annual medical deductible for the following year
- 12 month rate guarantee
|
|
Tips for Families... Families can save money with Vital Shield Plus by enrolling as a family (versus enrolling individually).
- Rates are often lower
- With 3 or more family members, total family deductibles and out-of-pocket maximum would be lower on a family plan versus individual plans
- Benefits are per member, so you don't have to share office visits
- These plans DO NOT include Maternity
|
The NEW Stand Alone Dental Plans now available...
  Blue Shield of California now offers a range of affordable and comprehensive dental plans available to residents of California with or without a Blue Shield health plan. With Blue Shield's broad dental network including nearly 20,000 dental PPO providers and more than 8,600 HMO providers in California it is easy to access one of the largest networks in California.
Blue Shield offers two new PPO dental plans to choose from. The new Smile PPO and the Value Smile PPO dental plans both provide you affordable options to help you stay healthy now and avoid costly dental expenses in the future. The savings you will receive with the Smile PPO plan keep the cost of dental work from taking a deep bite our of your wallet later. The Value Smile PPO plan provides preventive, diagnostic, and some minor restorative services designed to aid in reduction of future costly services. Find out more on these two new plans and how to enroll by clicking here..... |
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 click on the Agent Assist link to the right or call us at 619.435.6700. |
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)
- Have questions? Then give us a call or complete the SALES ASSISTANCE form to the right. We will call you.
- Applying is easy - simply complete the application process online from the comfort of your home or office. Ready to Apply? Click Here...
|
|
|
|
|
 |
|
|
Deductible and out-of-Pocket Maximum options... |
| |
|
|
| |
Vital Shield |
Vital Shield Plus |
 |
|
| Available for |
Vital Shield
900 |
Vital Shield
2900 |
Vital Shield
400 Plus |
Vital Shield
900 Plus |
Vital Shield 2900 Plus |
| |
|
|
|
|
|
Deductible |
$900 |
$2,900 |
$400
($800 family) |
$900
($1,800 family) |
$2,900
($5,800 family) |
Out-of-Pocket Maximum |
$4,900 |
$5,900 |
$3,900
($5,800 family) |
$3,900
($7,800 family) |
$4,900
($9,800 family) |
Lifetime Maximum |
$3,000,000 |
$3,000,000 |
$3,000,000 |
$3,000,000 |
$3,000,000 |
|
|
|
|
Vital Shield and Vital Shield Plus Plan Options
(Click the link below for more specific plan information) |
|
|
|
|
|
|
 |
Vital Shield Plus 900 Plan
(To Viewfull brochure details click here) |
 |
|
|
| This matrix is inteneded to be used to help you compare coverage benefits and is a summary only. The policy for individuals and families should be consulted for a detailed description of coverage benefits and limitations. |
Plan Benefits |
In-Network
(Receive negotiated savings) |
Out-of-Network
(Pay higher costs) |
 |
Annual Deductible
(Not combined for In-Network & Out-of-Network) |
Individual: $900
Family : $1,800 |
Individual: $900
Family : $1,800 |
If the annual plan deductible has not been met, any charges that accumulate toward the plan deductible in the last three month of the calendar year will be credited towards the plan deductible for the following calendar year will be credited towards the plan deductilble for the following calendar year. |
Calendar-year copayment / coinsurance maximum
(Includes the plan deductible - some service do not apply)
|
Individual: $3,900 |
Individual: $15,000 |
| Family: $7,800 aggregate |
Familiy: $30,000 aggregate |
Lifetime Maximum
(Combined for In-Network & Out-of-Network) |
Plan pays up to $3 Million per member |
Covered Services
The amounts shown are your share of costs after any deductible unless noted. |
In-Network
(Coinsurance amounts are
percentage
of negotiated fee) |
Out-of-Network
(Coinsurance amounts are percentage
of negotiated fee, plus any amounts
charged over that fee) |
| Professional Services |
|
|
| Office Visits - (first 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum) |
$30 |
No charge after copay maximum |
| Preventive Care |
|
|
| Annual routine phsyical exam, well-baby care office visits, and gynological exam office vist -
(first 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum) |
40% of negotiated fee |
Not Covered |
| Annual Pap test or other or other approved cervical cancer screening tests, routine mammography, and immunizations when received as part of the annual exam or preventive care visit |
40% of negotiated fee |
Not Covered |
| Outpatient Services |
|
|
| Non-emergency services and procedures, outpatient surgery in hospital |
40% of negotiated fee |
50% |
| Outpatient surgery performed in an ambulatory surgery center |
40% of negotiated fee |
50% |
Outpatient or out-of-hospital X-ray & laboratory |
No charge after copay maximum |
No charge after copay maximum |
Covered Services
Subject to the plan deductible unless noted |
In-Network
(Receive negotiated savings) |
Out-of-Network
(Pay higher costs) |
| Hospitalization Services |
|
|
| Inpatient physician visits and consultations, surgeons and assistants, and anesthesiologists |
40% of negotiated fee |
50% |
| Inpatient semiprivate room and board, services and supplies, and subacute care |
40% of negotiated fee |
50% |
| Bariatric surgery inpatient services (pre-authorization required: medically necessary surgery for weight loss, only for morbid obesity) |
40% of negotiated fee |
50% |
| Emergency Health Care |
|
|
| Emergency room services ($100 copayment/visit waived if member is admitted directly to the hospital as in inpatient) |
$100/visit +40% |
$100/visit + 40% |
| ER Physician visits |
40% |
40% |
| Ambulance Services |
40% |
40% |
| Prescription Drug Coverage |
Participating Pharmacies
(up to 30-day supply) |
Mail Service Prescriptions
(up to a 60-day supply) |
| Vital Shield Plus 400, 900 and 2900 Generic Rx are also available. These plans do not cover Brand-name drugs. All other benefits are the same. |
| Generic formulary drugs |
$10/presecription |
$20/prescription |
| Formulary brand-name drugs |
$45/prescription |
$90/prescription |
| Non-formulary brand-name drugs |
Not Covered |
Not Covered |
| Brand-name drug Deductible (brand-name drugs are subject to a brand-name drug deductible per person, per calendar year) |
$500 |
$500 |
Consider Other Blue Shield of California PPO Plans |
|
|
|
|
|
|
|
|
|
|
Anthem California
