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Blue
Shield PPO Shield Savings 3500 /
7000 (HSA Compatible) |
| Oleg
Skurskiy An Authorized Agent of Blue
Shield of California Call : (818)
654-4548 |
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or View Benefits Click Here
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In
Network |
Out
Of Network |
| Annual Deductible |
Individual: $3,500 Family: $7,000 |
Individual: $5,000 Family: $10,000 |
| Annual Out-Of-Pocket Limit |
Individual: $5,000 Family: $10,000 |
Individual: $15,000 Family: $30,000 |
| Lifetime Maximum |
$6,000,000 |
$6,000,000 |
| Office Visits |
No Charge after Deductible |
50% |
| Prescription Drugs |
After deductible, Generic: $10 Brand Formulary: $35
Brand Non-Formulary $50 or 50%,
whichever is greater (maximum
of $150 per prescription) |
Not Covered |
| Laboratory and Radiology |
No Charge after Deductible |
50% |
| Annual Physical Exam |
No Charge |
Not Covered |
| Annual OB-GYN Exam |
No Charge |
Not Covered |
| Well Baby Care |
No Charge |
Not Covered |
| Outpatient Surgery |
No Charge after Deductible |
50% ($300 maximum benefit per day) |
| Emergency Room |
$100/visit (waived if admitted) |
$100/visit (waived if admitted) |
| Ambulance |
No Charge after Deductible |
No Charge after Deductible |
| Home Health Care |
No Charge after Deductible (90 visits per year) |
Not Covered |
| Mental Health Services - Outpatient |
No Charge after Deductible (20 visits per
year) |
Not Covered |
| Chiropractic Care |
30% (maximum benefit $25, 20 visits per year) |
Not Covered |
| Acupuncture / Acupressure |
25% MyLifePath Discount |
Not Covered |
| Inpatient Hospital |
No Charge after Deductible |
50% ($300 maximum benefit per day) |
| Maternity Care |
Not Covered |
Not Covered |
| Mental Health - Inpatient |
No Charge after Deductible |
50% ($300 maximum benefit per day) |
| Chemical Dependency - Inpatient |
No Charge after Deductible |
50% ($300 maximum benefit per day) |
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Submitting
through the online
tool today! . If you are using
the Mac computer , please print
out the paper
application and mail or fax
to us .
| By
Fax : 818-776-9865 |
By
Mail: Oleg
Skurskiy
18375 Ventura Blvd. # 226
Tarzana , CA 91356 |
Ready
to Apply? Call us (818) 654-4548
|
We offer four high-deductible health plans
-- called Shield Spectrum PPO Savings
Plans -- that are eligible for use with
a Health Savings Account (HSA).
These plans offer affordable coverage
for a high-cost medical event while helping
you meet your essential healthcare needs.
They are often selected by people who
go to the doctor occasionally.
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Coinsurance amounts represented with
a "%" are payable after the
plan deductibles are reached; Co-pay amounts
represented with a "$" 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. 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!
The rate and benefit information provided
herein was generated by the Quotit Corporation's
individual health insurance quoting system.
The Quotit Corporation or It's Licensee's
do not guarantee or warrant the correctness
or completeness of the rate and benefit
information contained herein and shall
not be liable for any loss or damage arising
out of use of the quoted rate and benefit
information.
Additionally, 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. Your
grant of access to the rate and benefit
summaries contained herein may not be
relied upon as a guarantee of your eligibility
or coverage under these benefit plans.
Blue
Shield of California Life & Health
Insurance Company Life was formed in 1954
as a wholly owned subsidiary of Blue Shield
of California to provide a full range
of insurance products for their customers.
With 3.3 million members and $7.5 billion
in annual revenue, Blue Shield of California
is the state's third largest health plan.
Founded in 1939 and headquartered in San
Francisco, Blue Shield is a not-for-profit
corporation with approximately 4,300 employees
and more than 20 offices throughout California.
Blue
Shield of California Life & Health
Insurance Company Life has grown by offering
competitive insurance products including
Group Term Life, Accidental Death &
Dismemberment, Blue Shield of California
Life & Health Insurance Company Life
Vision Plan, Stop Loss and Exec-U-Med
medical reimbursement plans in tandem
with Blue Shield of California health
plans or on a stand-alone basis . In the
early 1980s, introduced their Short-Term
Health products. The Option One and Option
Twelve plans remain one of the leading
products of their kind in California |
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Copyright © 2005 Oleg Skurskiy Authorized
Independent Agent, CA License 0E50389 |
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