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Blue Shield PPO Plans

After more than 60 years of operation, Blue Shield of California has become one of the largest health insurance providers in the state. What makes Blue Shield of California so popular with its 3+ million members are the feature health coverage plans it offers for both families and individuals.

When you are comparing health coverage options, you must first consider how much money you want to allocate for your monthly premiums. You will also need to decide on the out-of-pocket medical expenses, co-payments and related expenses you are willing to handle yourself.

Then you will decide whether you prefer an HMO or a PPO. An HMO, or Health Maintenance Organization, plan requires a co-payment from you for every doctor visit or hospital stay. Although you do not typically have to meet a deductible, HMOs limit you to certain physicians in a particular network. That is why many Blue Shield of California members prefer PPO, or Preferred Provider Organization, plans.

Shield Secure Plus

Each PPO plan gives you the flexibility to choose the type of coverage best for you and your family. For example, Shield Secure Plus includes preventive care services, some of which do not require a co-payment. Your doctor visits likely will require a co-pay; however, the payments are not like those in many other plans, starting out high and decreasing when you meet the deductible. Instead, the co-pay is low regardless of whether or not the deductible is met.

This plan also provides for alternative care such as acupuncture and chiropractic coverage. Brand name and generic prescription drug coverage are included as well. Finally, the Shield Secure Plus allows you to choose from three deductible options: $2,000, $4,000 and $6,000.

Shield Secure

The Shield Secure plan offers the same deductible options as the Shield Secure Plus plan, and preventative care services are still covered under it. It includes some of the same benefits as the other plans, like low co-pays before meeting your deductible, brand name and generic prescription drug coverage, and acupuncture and chiropractic coverage.

However, preventative care does not include co-payments; so and you may pay, for example, $30 for each doctor visit. Your access to preventive care services such as a wellness visits are available at no charge. It differs from the Shield Secure Plus plan in that (while your payments are lower) your contribution to many treatment costs will be somewhat higher.

Shield Saver

The Shield Saver plan is also compatible with your Health Saving Account (HSA). The plan benefits are similar to the other Blue Shield of California health plans. For instance, the plan includes preventive care services, chiropractic and acupuncture coverage and brand name and generic prescription coverage.

One major advantage is that preventive care services are still available without a co-payment before you meet your deductible, a feature that many savings-focused plans do not offer. This plan offers low monthly rates with two deductible options: $4,000 and $6,000. Once your deductible is paid, the plan covers 100 percent of the cost of most of your covered services for the remainder of the year. This may include the cost of certain prescriptions.

The plan also allows you to use some of your HSA toward your qualified medical expenses. Thus, the Shield Saver plan offers some of the lowest available monthly rates and low out-of-pocket costs on major medical events.

Shield Wise

This plan is intended for individuals who are relatively healthy, but want great protection in case of any unexpected medical emergencies or illnesses. Preventative care services are typically covered, as are treatments like acupuncture and chiropractic services. Plan benefits include three annual office visits. You also receive one physical examination each year without paying a co-payment. In addition, you receive two more office visits that require you to pay a fixed co-pay amount.

The Shield Wise plan gives you flexibility regarding how much deductible and coinsurance you want to handle. You can choose from a $2,500, $3,500 or $4,500 deductible. Your fixed co-pay for the two office visits depends on the option you choose. For instance, if you choose a $4,500 deductible, your two office visits cost $45 each.

Finding the Right PPO Plan for You

Blue Shield of California has a PPO option that will work for anyone. By looking at such factors as your financial situation, your health and the level of security you prefer, you can choose the plan that meets your needs.

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