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Access + ValueBlue Shield Logo

The Access + Value plan from Blue Shield of California features the following:

Plan Type: HMO
Deductible: $2,000
In-Patient Hospital Co-Payment/Coinsurance: 40%
Prescription Drug Coverage (Out Patient): Yes
Maternity Coverage Included: Yes

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Access + Value Summary:

In Network Out of Network
Annual Deductible Individual: $2,000 Family: $4,000 Not Applicable
Annual Out-Of-Pocket Limit Individual: $4,000 Family: $8,000 Not Applicable
Lifetime Maximum Unlimited Not Applicable
Office Visits $35 Not Applicable
Prescription Drugs Generic: $10 Brand Formulary: $35 ($400 Brand Deductible) Not Applicable
Laboratory and Radiology $35 Not Applicable
Annual Physical Exam $35 Not Applicable
Annual OB-GYN Exam $35 Not Applicable
Well Baby Care $35 Not Applicable
Outpatient Surgery 40% Not Applicable
Emergency Room $150 (waived if admitted), No Charge After Deductible $150 (waived if admitted), No Charge After Deductible
Ambulance $50 Not Applicable
Home Health Care $35 (100 visits per year) Not Applicable
Mental Health Services - Outpatient $35, $50 MHSA Specialist per visit (20 visits per year) Not Applicable
Chiropractic Care 25% MyLifePath Discount Not Applicable
Acupuncture / Acupressure 25% MyLifePath Discount Not Applicable
Inpatient Hospital 40% per admission Not Applicable
Maternity Care 40% per admission Not Applicable
Mental Health - Inpatient 40% per admission Not Applicable
Chemical Dependency 40% per admission Not Applicable

 

IMPORTANT NOTICE: 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. Out of pocket maximum shown includes the plan deductible unless otherwise noted. 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!

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.

 

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