SmartSense 3500 Plus Upgrade Rx 1 Member

The SmartSense 3500 Plus Upgrade Rx 1 Member plan from Blue Cross of California (Anthem Blue Cross) features the following:

Plan Type: PPO

Deductible: $3,500

In-Patient Hospital Co-Payment/Coinsurance: 30%

Prescription Drug Coverage (Out Patient): Yes

Maternity Coverage Included: 30%

Obtain a free quote now for the SmartSense 3500 Plus Upgrade Rx 1 Member plan and compare to other Blue Cross plans.

SmartSense 3500 Plus Upgrade Rx 1 Member Summary:

	In Network	Out of Network
Annual Deductible	Individual: $3,500 Family: $7,000	Individual: $3,500 Family: $7,000
Annual Out-Of-Pocket Limit	Individual: $3,500 Family: $7,000 (Deductible not Included)	Individual: $7,500 Family: $15,000 (Deductible not Included)
Lifetime Maximum	Unlimited	Unlimited
Office Visits	$30 first 3 visits/member/year then 30%	50%
Prescription Drugs	Generic: $15 Brand: $40 Non-Formulary Brand: $60 ($500 Brand Deductible, see brochure for details)	50%
Laboratory and Radiology	30%	50%
Annual Physical Exam	No Charge	50%
Annual OB-GYN Exam	No Charge	50%
Well Baby Care	No Charge	50%
Outpatient Surgery	30%	All Charges Except $380/day after Deductible
Emergency Room	30% plus $100 (Waived if admitted)	30% plus $100 (Waived if admitted)
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	See Brochure	See Brochure
Inpatient Hospital	See Brochure	See Brochure
Maternity Care	30%	50%
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.