Anthem Blue Cross of California's individual 3500 PPO HSA compatible medical insurance plan represents the latest trend in California health insurance policies: low monthly premium and coverage for catastrophic illness or injury. Unfortunately, this plan DOES NOT include maternity costs, so it is not a good choice for someone planning a family. The 3500 PPO HSA plan has a relatively high calendar year deductible of 3500. This means that a person enrolled on this health insurance plan would pay all of the costs for medical care up to $3,500. After that point the plan generally pays 100 percent of the medical costs. Another way of saying this is that the insurance company pays nothing until you have paid $3,500 for medical expenses. Of course one of the very valuable benefits of the Anthem Blue Cross of California 3500 PPO medical insurance plan is that members are able to access doctors and hospitals in the Blue Cross network and pay a reduced, or discounted, amount, referred to as the "negotiated rate." Blue Cross providers (i.e., doctors, hospitals, labs and other "in-network" medical professionals) have agreed to accept lower fees for their services in exchange for referrals of patients from Blue Cross of CA. Accordingly, when a Anthem Blue Cross member enrolled on the 3500 PPO California Health Savings Accounts plan is sick, injured or other wise needs medical attention, he/she is wise to use an in-network medical provider. That provider will bill Blue Cross of California directly and the patient should not have to pay any money to the provider at the time of the visit or hospital admission. When Blue Cross of California receives the claim request from the provider for the cost of the member's service, Blue Cross will discount the amount billed and send an "Explanation of Benefits" (often referred to as an "EOB") to the member which shows the amount the provider billed, the discount Blue Cross applied and the amount that the member must pay for the medical services rendered. The member then pays the provider according to the EOB. On the 3500 PPO plan a member would pay all discounted costs for medical care up to $3,500 - including prescription medicine costs. The beauty of this plan is the low monthly premium that the member pays. Someone who is 49 years old or younger and living in West Los Angeles (one of the most expensive areas for Blue Cross health insurance) would pay only $105 per month for this health plan. That is only $1,260 per calendar year. Add the $3,500 deductible and the total out of pocket is $4,760 per year for a plan that would pay 100 percent of medical expenses. This is the worst case scenario where a member gets very sick or has an accident and must pay the entire calendar year deductible. A final benefit of the Anthem Blue Cross of California 3500 PPO plan is that it is compatible with California Health Savings Accounts and one can pre-fund the 3500 deductible in an HSA account. |
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California Health Insurance |
Group Health Insurance in California |
Health Savings Accounts | |
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