Vimo Editorial: Health Plan Profile
Editorial review written by Erik Espe, Vimo Research Group
Source: Blue Cross Of California brochure
Last Updated: 03/28/2007
Blue Cross of California's Basic PPO is one of the cheapest that BC offers in the
Golden
State
, so benefits are limited. There are no prescription benefits and office visits are covered only after you have burned through the $1,500 annual deductible and an additional $2,500 in coinsurance to reach the out-of-pocket maximum (OOPM). Hospital expenses, however, are covered after the deductible, but include a 20% fee charged to you (until you've spent your OOPM).
You'll enjoy some preventive care benefits with the 20% coinsurance fee as well – even before you've spent your deductible, including a mammogram, Pap and PSA tests. For a co-payment of $25 or $75 (depending on the level of health screening you request), you also qualify for a pre-deductible annual routine check-up through a HealthyCheck center.
With a lifetime maximum benefit of $5,000,000 and one of the best PPO networks in
California
, the Basic PPO 1000 is a solid, cheap health plan.
BEST FOR: Individuals looking for coverage for medical emergencies from a plan that offers some limited pre-deductible benefits.
PROS: Preventive care benefits and routine check-ups that can be taken advantage of before you've spent your deductible. Blue Cross' solid network in
California
means you don’t have to worry about finding care in the event of a medical emergency.
CONS: All the usual negatives about a high-deductible, low-priced health plan. You will need to spend $1,000 before you enjoy any hospital benefits, and then burn through an additional $2,500 in coinsurance before the plan covers 100 percent of your hospital expenses. But you make up for this in lower premiums. Additionally, there are no drug benefits.