PPO (Preferred Provider Organization) cont.

$1,700 and $2,400 Individual Deductible Plans / $3,400 and $4,800 Two-Party or Family
These plans offer essential coverage needs and protection against major healthcare expenses, but at a lower monthly cost than the Deductible plans.

Features-

• For people who want catastrophic coverage
• In most cases, Blue Shield's lowest monthly rates
• Preventive care benefits before you meet the deductible
• Prescription drug benefits at any retail pharmacy

Rates-

Preferred Savings Plan Options		Individual Coverage		Two-Party/Family Coverage
Deductibles		$1,700	$2,400	$3,400	$4,800
Physician Services (i.e. office visits)		30% w/ Choice Provider 40% w/ Affiliated Provider		30% w/ Choice Provider 40% w/ Affiliated Provider
Prescription Drug Coverage		Member pays full price and submits claim to Blue Shield. After deductible is met, 30% copayment applies.
Monthly Rates		$68	$46	Two-Party -$134 Family - $219	Two-Party - $90 Family - $149

BLUE CROSS (CA) Plan Comparison

	PPO Share 1000	PPO Share 1500	PPO Share 2500	PPO Share 500
Annual Out-of-Pocket Maximum (includes deductible)	$4,000 per single	$4,000 per single	$5,000 per single	$4,000 per single
Annual Deductible	$1,000 per member	$1,500 per member	$2,500 per member	$500 per member
Office Visits	40% of well-child; office visits, 30% of negotiated fee	40% of well-child; office visits, 30% of negotiated fee	40% of well-child; 30% of negotiated fee for other services	40% of well-child; office visits, 30% of negotiated fee
Drug Benefits	$10 generic, $30 brand copay plus $250 brand deductible	$10 generic, $30 brand copay plus $250 brand deductible	$10 generic, $30 brand copay plus $500 brand deductible	$10 generic, $30 brand copay plus $250 brand deductible
Monthly Rates	Individual- $106 Two-Party-$242 Family-$368	Individual- $88 Two-Party-$197 Family- $305	Individual- $52 Two-Party-$102 Family- $204	Individual- $164 Two-Party-$319 Family- $458

	Basic PPO 1000	PPO Share 5000	PPO Saver
Annual Out-of-Pocket Maximum (includes deductible)	$3.500 per single	$7,500 per single	$5,000 per single
Annual Deductible	$1,000 per member	$5,000 per member	$500 hospital, $5,000 other covered services
Office Visits	None until out-of-pocket max met, then 100%	40% of well-child; 30% of negotiated fee for other services	50% of well-child; $30 copay/ visit (2-adult, 4-child office visits)
Drug Benefits	Not covered	$10 generic, $35 brand copay plus $750 brand deductible	$10 generic, $30 brand copay plus $500 brand deductible
Monthly Rates	Individual- $47 Two-Party-$80 Family- $128	Individual- $35 Two-Party-$68 Family- $99	Individual- $62 Two-Party-$120 Family- $172

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