Individual plans are for people who want to buy coverage for themselves outside of employer-sponsored coverage
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Popular Medical Plans for California 2018 Summary of Benefits :
Primary care visit: $15 Primary care visit: $25 Primary care visit: $35
Lab: $15 copay Lab: $35 copay Lab: $35 copay
Hospitalization: 10% coinsurance Hospitalization: 20% coins. Hospitalization: 20% coins. after deductible
Bronze plans (have lower premiums, but higher out of pocket expenses):
Blue Shield Bronze 60 PPO Blue Shield Bronze 60 HDHP PPO
Deductible: $6300 Deductible: $4,800
Primary care visit: $75 (first 3 visits)* Primary care visit: 40% coinsurance
Lab: $40 copay Lab: 40% coinsurance
Hospitalization: 100% coinsurance Hospitalization: 40% coinsurance
-This plan is HSA compatible
Blue Shield Plans available only through CoveredCa (subsidized based on income)
Blue Shield Silver 94 PPO Blue Shield Silver 87 PPO Blue Shield Silver 73 PPO
Deductible: $75 Deductible: $650 Deductible: $2,200 per individual
Primary care visit: $5 Primary care visit: $10 Primary care visit: $30
Lab: $8 copay Lab: $15 copay Lab: $35 copay
Hospitalization: 10% coinsurance Hospitalization: 15 % coins. Hospitalization: 20% coins.
Other Blue Shield Medical Plans:
Blue Shield Silver 1850 PPO Blue Shield Minimum Coverage PPO
Deductible: $1850 Deductible: $7350
Primary care visit: $45 Primary care visit: subject to deductible
Lab: $30% coinsurance Lab: subject to deductible
Hospitalization: 30 % coins. Hospitalization: subject to deductible
This is not the complete list of coverage and is subject to change. For specific details of your plan, please refer to the summary of benefits or your evidence of coverage. The above deductible, primary care visit, lab and coinsurance are common when using the network providers. You will pay more if using out of network providers.
* The first 3 visits (or after first visit) are available prior to meeting the calendar-year medical deductible and include a combination of primary care physician, urgent care, acupuncture, outpatient mental health, outpatient substance abuse and other practitioner visits Subsequent visits are subject to the calendar year medical deductible.
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