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CoreGuard 1000 1 Member

The CoreGuard 1000 1 Member plan from Blue Cross of California (Anthem Blue Cross) features the following:

Plan Type: PPO
Deductible: $10,000
In-Patient Hospital Co-Payment/Coinsurance: $0
Prescription Drug Coverage (Out Patient) Yes
Maternity Coverage Included: Yes

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CoreGuard 1000 1 Member Summary:

In Network Out of Network
Annual Deductible None Individual: $7,000 Family: $14000
Annual Out-Of-Pocket Limit Individual: $10,000 Family: $20,000 Individual: $7,500 Family: $15,000 (deductible not Included)
Lifetime Maximum No Charge after Deductible 30%
Prescription Drugs Tier 1: $15 Tier 2: $35 ($2,000 Deductible per member for Tier 2) Not Covered
Laboratory and Radiology No Charge after Deductible 30%
Annual Physical Exam $25/$75 Co-Pay at HealthyCheck Centers for Basic/Premium Screening Not Covered
Annual OB-GYN Exam No Charge after Deductible 30%
Well Baby Care See Brochure See Brochure
Outpatient Surgery No Charge after Deductible 30%
Emergency Room No Charge after Deductible No Charge after Deductible
Ambulance See Brochure See Brochure
Home Health Care See Brochure See Brochure
Mental Health Services - Outpatient See Brochure See Brochure
Chiropractic Care See Brochure See Brochure
Acupuncture / Acupressure Not Covered Not Covered
Inpatient Hospital No Charge after Deductible 30%
Maternity Care Covered Covered
Mental Health - Inpatient See Brochure See Brochure
Chemical Dependency See Brochure See Brochure


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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