The Anthem Blue Cross of California PPO Share 2500 medical insurance plan offers good value. It has a very low premium and offers protection against major financial ruin from catastrophic medical care cost. Beware, however, an individual or family enrolled in this assumes a huge liability for their medical care with this plan. Positive Features of this California Anthem Blue Cross Health Insurance Plan:
This health insurance plan has a $2,500 calendar year deductible. The deductible is waived for doctor's office visit charges and a member pays only 30 percent of the discounted rate that Blue Cross of California has negotiated with participating doctors. The doctor's office visit is the medical billing code that includes:
After a member has paid the $2,500 deductible, Anthem Blue Cross pays 70 percent of the negotiated fee for medical services and the member pays 30 percent. When the member has paid a total of $7,500 (including the $2,500 annual deductible) California Anthem Blue Cross Health Insurance will pay 100 percent of the charges for medical services, subject to the exclusions and limitations described in the Evidence of Coverage. Each member of a family enrolled on the PPO Share 2500 health plan would have to pay a separate $2,500 deductible with a maximum of two deductibles per family per year. This means that if two people in a family get very ill and must pay the deductible then none of the other members of a family would need to satisfy the deductible. The maximum out of pocket expense for a family is capped at $7,500 per member with two per family per year. This means that in the worst case where two members of a family met the out of pocket maximum of $15,000 per year then Anthem Blue Cross of California health insurance would pay all of the allowed medical expenses of the other family members. The calendar year deductible is included in the $15,000 family maximum so that a family would have had to have incurred $33,333 of allowable medical expenses ($10,000 divided by 30 percent) plus the $5,000 of two separate deductible. So a family would have had $38,333 of medical expenses, of which they would have paid $15,000 and Blue Cross would have paid $23,333. The PPO Share 2500 plan also includes generic prescription medication for only $10 for a 30 day supply. The co-payment for brand medications is $30 - after a separate $500 Rx deductible. So, the plan will pay for brand medication, but a member must pay the deductible, two per family. The Anthem Blue Cross PPO Share 2500 does cover maternity, so it may be a great plan for someone looking to start a family. It is certainly very inexpensive. Remember that this article merely summarizes the benefits. Please refer to the Evidence of Coverage and the Summary of Benefits from Blue Cross of California for detailed benefit information. |
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California Health Insurance |
Group Health Insurance in California |
Health Savings Accounts | |
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