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Blue Shield Spectrum PPO Savings Plan 4000 / 8000
Oleg Skurskiy An Authorized Agent of Blue Shield of California Call : (818) 987-5000
 

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We offer four high-deductible health plans -- called Shield Spectrum PPO Savings Plans -- that are eligible for use with a Health Savings Account (HSA).

These plans offer affordable coverage for a high-cost medical event while helping you meet your essential healthcare needs. They are often selected by people who go to the doctor occasionally.

Get more details about the Shield Spectrum PPO Savings Plan 4000/8000 (PDF, 102 KB)
 
Bluie Shield Spectrum Savings 4000 Single  In-Network Out-Of-Network
 
  • Annual Deductible  
 Individual: $4,000 Individual: $4,000
  • Maximum Annual Co-pay  
 Individual: $4,000 Individual: $4,000 
  • Lifetime Maximum  
 $6,000,000 $6,000,000
  • Office Visits  
 No Charge after Deductible 50%
  • Prescription Drugs  
 No Charge after Deductible No Charge after Deductible
  • Laboratory and Radiology  
 No Charge after Deductible 50%
  • Annual Physical Exam  
 $35 Not Covered
  • Annual OB-GYN Exam  
 $35 Not Covered
  • Prenatal / Postnatal Maternity  
 Not Applicable Not Applicable
  • Well Baby Care  
 $35 Not Covered
  • Outpatient Surgery  
 No Charge after Deductible 50% ($300 maximum benefit per day)
  • Emergency Room  
 No Charge after Deductible No Charge after Deductible
  • Ambulance  
 No Charge after Deductible No Charge after Deductible
  • Home Health Care  
 No Charge after Deductible (90 visits per year) Not Covered
  • Mental Health Services  
 No Charge after Deductible (20 visits per year) Not Covered
  • Chiropractic Care  
 No Charge after Deductible (maximum benefit $25, 12 visits per year) Not Covered
  • Acupuncture / Acupressure  
 25% MyLifePath Discount Not Covered
  • Inpatient Co-payment  
 No Charge after Deductible 50% ($300 maximum benefit per day)
  • Maternity Care
 Not Covered Not Covered
  • Inpatient Mental Health 
 No Charge after Deductible 50% ($300 maximum benefit per day)
  • Chemical Dependency  
 No Charge after Deductible 50% ($300 maximum benefit per day)
Active Start Plan 35 PPO - No Medical Deductible   Shield Spectrum PPO 5000   Access®+ Value HMO
Active Start Plan 25 PPO - No Medical Deductible   Shield Spectrum PPO 2000   Access®+ HMO
Balance Plan PPO 1000 - no Maternity   Shield Spectrum PPO 1500    
Balance Plan PPO 1700 - no Maternity   Shield Spectrum PPO 750   Blue Shield Senior
Balance Plan PPO 2500 - no Maternity   Shield Spectrum PPO 500    
Essential Plan PPO 1750 Dental & Vision Included   Blue Shield Short Term
Essential Plan PPO 3000 Dental & Vision Included HSA Savings Plan 2400 / 4800  
Essential Plan PPO 4500 Dental & Vision Included HSA Savings Plan 4000 / 8000  

 

Coinsurance amounts represented with a "%" are payable after the plan deductibles are reached; Co-pay amounts represented with a "$" are not subject to plan deductibles (except where noted). Refer to contract for a detailed explanation of plan benefits, features, exclusions and limitations. Benefits subject to change without notice. Co-pays, Deductibles, and Coinsurance amounts listed above are your share of the costs for covered benefits.

Do Not Cancel your current coverage until a new policy is approved and you have received written confirmation of the policy's rates and benefits from the insurance company. Rate and Benefit Disclaimer Notification! The rate and benefit information provided herein was generated by the Quotit Corporation's individual health insurance quoting system. The Quotit Corporation or It's Licensee's do not guarantee or warrant the correctness or completeness of the rate and benefit information contained herein and shall not be liable for any loss or damage arising out of use of the quoted rate and benefit information.

Additionally, information contained in this website is limited in scope, subject to change without notice, and does not contain all the terms, conditions, limitations, or exclusions of the referenced benefit plans. Only the insurance company Plan Documents and Policy's contain the exact terms and conditions of coverage. Your grant of access to the rate and benefit summaries contained herein may not be relied upon as a guarantee of your eligibility or coverage under these benefit plans.

Blue Shield of California Life & Health Insurance Company Life was formed in 1954 as a wholly owned subsidiary of Blue Shield of California to provide a full range of insurance products for their customers. With 3.3 million members and $7.5 billion in annual revenue, Blue Shield of California is the state's third largest health plan. Founded in 1939 and headquartered in San Francisco, Blue Shield is a not-for-profit corporation with approximately 4,300 employees and more than 20 offices throughout California.

Blue Shield of California Life & Health Insurance Company Life has grown by offering competitive insurance products including Group Term Life, Accidental Death & Dismemberment, Blue Shield of California Life & Health Insurance Company Life Vision Plan, Stop Loss and Exec-U-Med medical reimbursement plans in tandem with Blue Shield of California health plans or on a stand-alone basis . In the early 1980s, introduced their Short-Term Health products. The Option One and Option Twelve plans remain one of the leading products of their kind in California
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Copyright © 2005 Oleg Skurskiy Authorized Independent Agent, CA License 0E50389