Basic PPO and PPO Saver Plans

The Basic PPO and PPO Saver Plans offer in-hospital and surgical coverage with low affordable monthly premiums. These plans are designed to protect against great financial losses due to unexpected illness or injury. Both plans offer limited coverage for professional services; however, for a slightly higher premium, the PPO Saver Plan provides more covered professional services.

PPO Plan Highlights

• Direct access to the doctors, hospitals and specialists of your choice
• Immediate (deductible-free) benefits for office visits and generic drugs (except for the Basic PPO 1000 plan)
• Payment at 100% for most covered services once you've met your out-of-pocket maximum
• Coverage up to $5 million in benefits over your lifetime
• Annual wellness screenings through HealthyCheck centers
• MedCall 24-hour nurse access
• Access to participating doctors and facilities nationwide through the BlueCard program when you travel

HMO PLAN SELECTIONS

The Blue Cross Individual HMO Plan provides extensive coverage with low out-of-pocket costs for covered health care services you received only from HMO Network doctors and hospitals.

The Blue Cross HMO Saver Plan provides the same coverage as the Individual HMO Plan, but has a deductible amount for services you receive from hospitals and other health facilities to keep the premiums lower.

For more information on what each plan covers, see complete brochures below ▼

When you visit a Blue Cross participating doctor, most of our PlanScape® plans require you to pay 20% or 30% of the negotiated cost of the visit.  For a typical office visit, that 20% or 30% is less than the fixed co-payments required by our competitors.

For example, the average negotiated cost of office visits to Blue Cross doctors is $60.

With PlanScape® you pay:

20% of $60 = $12 or 30% of $60 = $18

That's less than our competitors' co-payment plans that require you to pay co-payments of $20,$25,$30,$35 or $40!

Preventive Care Screenings

Take Control
Your health is your most important asset. Blue Cross helps put you in control of your health through affordable preventive care screenings that promote your physical well being. Staying healthy supports an active and fulfilling lifestyle.

Know Your Health
The HealthyCheck program offers members an annual preventive care screening that evaluates a variety of health risks. Screening results may confirm good health, identify where health may be improved, and may also reveal conditions that need further evaluation by your doctor.

Other Things You Should Know

• Trained, licensed health care professionals administer all screenings. They will review screening results and lifestyle recommendations with you at your HealthyCheck screening appointment.
• If you do not receive a flu shot during your screening because it is not flu season, you will be eligible for a future flu shot during flu season at no charge through a HealthyCheck provider.
• About 10 days before your appointment, you'll receive a confirmation packet with instructions on how to complete your health status questionnaire (either paper or Internet version)
• For adults, HealthyCheck also offers an online method for accessing and monitoring your health. Visit the HealthyCheck Web site (www.blucrossca.com/healthcheck), and choose the Health Status Report link to access the Health Quotient (HQ) Questionnaire. Once you complete it, you will have a personal web page that includes your health profile. You will also receive a Health Quotient score with personalized messages highlighting health concerns, potential risks and steps you can take to improve your overall health.

When Traveling - BlueCard®Extend the Power of Blue

At no additional cost, the BlueCard program provides coverage for PPO plan members who suddenly become sick or have a medical emergency outside California. The BlueCard gives you access to doctors and hospitals in participating local Blue plan networks throughout the nation as negotiated rates.