Blue Cross of California Individual Family PPO Share 5000

Blue Cross of California
Individual PPO Share 5000

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California medical insurance

Individual Family

Blue Cross of California

PPO

Share 5000

BC Life & Health Share 5000	Other Blue Cross individual family plans Blue Cross of California HMO plans Blue Cross of California PPO plans
Plan Summaries (please get updated information by requesting a quote with your request effective date) Individual Family quote
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PPO Share 5000		In-Network	Out-Of-Network
	Annual Deductible	Individual: $5,000 Family: $10,000	Individual: $5,000 Family: $10,000
	Annual Out-Of-Pocket Limit	Individual: $7,500 Family: $15,000	Individual: $7,500 Family: $15,000
	Lifetime Maximum	$5,000,000	$5,000,000
	Office Visits	$40	50% - Deductible Waived
	Prescription Drugs	$10 Generic $35 Brand with $750 Annual Brand Deductible	50% of the Drug Limited Fee Schedule with $750 Annual Brand Deductible
	Laboratory and Radiology	30%	50%
	Annual Physical Exam	30% (Deductible Waived, $200 maximum benefit per year)	50% (Deductible Waived, $200 maximum benefit per year)
	Annual OB-GYN Exam	30% - Deductible Waived	50% - Deductible Waived
	Prenatal / Postnatal Maternity	Not Applicable	Not Applicable
	Well Baby Care	40% - Deductible Waived	50% - Deductible Waived
	Outpatient Surgery	30%	All Charges Except $380 per day
	Emergency Room	30% plus $100 (waived if admitted)	30% of customary and reasonable for the first 48 hours.After 48 hours:All charges except $650/day plus $100*
	Ambulance	30%	50%
	Home Health Care	See Benefit Contract	See Benefit Contract
	Mental Health Services	See Benefit Contract	See Benefit Contract
	Chiropractic Care	30% (12 visits per year)	All charges except $25 per visit (12 visits per year)
	Acupuncture / Acupressure	All charges except $25 per visit (24 visits per year)	All charges except $25 per visit (24 visits per year)
	Inpatient Co-payment	30%	All Charges Except $650 per day
	Maternity Care	30%	50%
	Inpatient Mental Health	See Benefit Contract	See Benefit Contract
	Chemical Dependency	All Charges Except $175 per Day (Detox)	All Charges Except $175 per Day (Detox)

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New BC Life & Health CORE 5000 , BC Life & Health Basic PPO 1000 blue cross of california CORE 5000

Blue Cross of California (BCC) and BC Life & Health Insurance Company (BCL&H) are Independent Licensees of the Blue Cross Association (BCA). The Blue Cross name and symbol are registered service marks of the BCA. The following plans are offered by BCC: PPO Share 2500/1500/1000/500, Individual HMO, HMO Saver, Select HMO, EPO and Dental SelectHMO. The following plans are offered by BCL&H: CORE 5000, Basic PPO 1000/2500, PPO Saver, PPO Share 5000/1000/500, RightPlan PPO 40, 3500 Deductible PPO, PPO 3500 (HSA-Compatible), Short-Term PPO, Tonik, Individual PPO Dental and Term Life

Blue Cross of California has been serving the health insurance needs of California residents since 1937. Blue Cross of California, together with its branded affiliates, provides health care services to more than 6.8 million members.

Offering a full continuum of product and coverage options, Blue Cross provides customers with unparalleled choice and flexibility in meeting their California health plan needs. These options are continually fine-tuned to enhance access to affordable, quality health care. The Company, with its strong track record for innovation, focuses on progressive products and services designed to improve the health status of all Californians. Unique product offerings available in the individual, small group, large group, senior and Medi-Cal markets include a full range of integrated medical and specialty products.

Further to our support of the Blue Cross and Blue Shield Association, Blue Cross of California is committed to lifting the quality of public debate on issues that affect California health care coverage.

Corporate Profile

- History of the Blue Cross and Blue Shield System

1929 A Baylor University administrator set out to make health care affordable for everyone.

By creating a local hospital pre-payment plan for public school teachers, Justin Ford Kimball made medical coverage available to the general public for the first time. The idea quickly attracted nationwide attention.

1936 The Great Depression had taken its toll on the American people and health care was virtually unaffordable.

A group of humanitarians, including Ritz E. Heerman and Howard Burrell, lobbied for legislation to authorize and govern hospital service plans in California.

Health care would be made affordable for Californians through the Associated Hospital Service of Southern California and the Alameda County Medical Association.

1939 The Blue Cross symbol was adopted by a commission of the American Hospital Association as a national emblem for plans that met certain guidelines in covering hospital care.

The first Blue Shield plan was founded in California in the same year to cover physicians' services.

1941 World War II changed many facets of American society. When soldiers returned home both families and the economy grew.

Blue Cross was able to provide Americans with added medical and surgical coverage. By the end of the 1940s, 35 million Americans were Blue Cross subscribers.

1950 Blue Cross thrived by improving benefits, increasing enrollment, cutting operating costs and building reserves.

1960 The 1960s brought very important changes to the Blue Cross organization. In 1965 President Johnson signed a bill which created Medicare and Medicaid.

Blue Cross was elected by most hospitals to process the Medicare and Medicaid claims.

The addition of this government program doubled the size of Blue Cross plans.

1970 A combination of inflation and rising health care costs during the 1970s caused Blue Cross to raise premiums, which caused alarm.

The price of malpractice insurance also increased dramatically, and the providers of insurance had to compensate.

1980 This was a period of dramatic growth for Blue Cross, and in 1982 Blue Cross of Northern California and Blue Cross of Southern California became one.

Blue Cross of California was born because the two plans had become very similar and the advances in technology made consolidation a practical option to increase efficiency.

1990 As the health care industry continued to grow in the 1990s, Blue Cross found it must learn to prosper in a buyer's market. Customer satisfaction became Blue Cross of California's number one priority, and it remains so today.

Focus on Quality

Health care has become more promising while at the same time more complicated and confusing. Consumers not only are dealing with issues of access and affordability, but also with questions about quality. At Blue Cross of California, we are committed to improving health care for all of us. And, that means a focus on quality. We use an integrated approach to improving quality of care and preventive health services. We also monitor and evaluate medical services to seek ways of improving them for our members. It's part of what we call "The Power Of Blue."

National Committee for Quality Assurance (NCQA)

Review from respected outside organizations is an important part of maintaining plan quality. The NCQA conducts a voluntary review process to evaluate how well a health plan manages all the parts of its delivery system in order to continuously improve health care for its members. We actively participate in this process and have implemented programs to ensure that we continue to meet these high standards.

Quality Management Notifications

Member Rights and Responsibilities (English) or (Espa�ol)

The Health Plan Employer Data and Information Set (HEDIS)

We also participate in HEDIS, which uses a set of indicators determined by the NCQA to consistently measure quality of care on an annual basis.

"HEDIS 2003 Report to Employers"

"HEDIS 2002 Quality Focus"

Medical Group Performance Profile

We developed a medical group report card to track important issues, such as patient satisfaction, access to care, health screenings and problem handling. It's part of our effort to be sure that our members are happy with us, their doctor and their other providers.

Preventive Health Programs

Our preventive health programs are designed to help members improve the quality of their lives through information on healthy living, access to preventive health care and care management for chronic conditions.

Publications

Our newsletters for members and providers share up-to-date information on healthy living tips, practice guidelines and current health initiatives.

Preventive Health Care Guidelines

These schedules for members and providers recommend screenings and immunizations for healthy infants, children, adolescents, adults and seniors.

Infant and Childhood Immunization Outreach

This reminder program targets parents, pediatricians and medical groups to promote on-time immunizations.

Health Management Programs

Qualified members with diabetes, asthma and congestive heart failure receive special health education materials and learn self-management skills to promote living well with chronic conditions.

Academic and Public Partnerships

Blue Cross of California collaborates with community organizations and accredited universities on various clinical research and development projects.

About Blue Cross of California