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Blue Shield of California Health Insurance in CALIFORNIA – Health Plan Options

Blue Shield of California — Access+ HMO

A comparison of the Access+ HMO offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	N/A	N/A
Office Visit	Professional Services: Personal Physician office visits: $20/visit Injectable medications, lab, and X-ray: $20 Access+ Specialist (self-referred physician office visits or other consultations only): $35/visit Physician home visits: $35	Professional Services: Personal Physician office visits: $20/visit Injectable medications, lab, and X-ray: $20 Access+ Specialist (self-referred physician office visits or other consultations only): $35/visit Physician home visits: $35
Copay	Professional Services: Personal Physician office visits: $20/visit Injectable medications, lab, and X-ray: $20 Access+ Specialist (self-referred physician office visits or other consultations only): $35/visit Physician home visits: $35	Professional Services: Personal Physician office visits: $20/visit Injectable medications, lab, and X-ray: $20 Access+ Specialist (self-referred physician office visits or other consultations only): $35/visit Physician home visits: $35
Deductible	$2,000 ($4,000 family)	$2,000 ($4,000 family)

Blue Shield of California — Access+ Value HMO

A comparison of the Access+ Value HMO offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	N/A	N/A
Office Visit	Professional Services: Personal Physician office visits: $35/visit Injectable medications, lab, and X-ray: $35 Access+ Specialist (self-referred physician office visits or other consultations only): $50/visit Physician home visits: $50	Professional Services: Personal Physician office visits: $35/visit Injectable medications, lab, and X-ray: $35 Access+ Specialist (self-referred physician office visits or other consultations only): $50/visit Physician home visits: $50
Copay	Professional Services: Personal Physician office visits: $35/visit Injectable medications, lab, and X-ray: $35 Access+ Specialist (self-referred physician office visits or other consultations only): $50/visit Physician home visits: $50	Professional Services: Personal Physician office visits: $35/visit Injectable medications, lab, and X-ray: $35 Access+ Specialist (self-referred physician office visits or other consultations only): $50/visit Physician home visits: $50
Deductible	$2,000 ($4,000 family)	$2,000 ($4,000 family)

Blue Shield of California — Active Start Plan 25

A comparison of the Active Start Plan 25 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: $25	Office Visits: 50%
Copay	$25 with preferred providers	Not applicable with non-preferred providers
Deductible	$0	$0

Blue Shield of California — Active Start Plan 25 Generic Rx

A comparison of the Active Start Plan 25 Generic Rx offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: $25	Office Visits: 50%
Copay	$25 with preferred providers	Not applicable with non-preferred providers
Deductible	$0	$0

Blue Shield of California — Active Start Plan 35

A comparison of the Active Start Plan 35 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: $35	Office Visits: 50%
Copay	$35 with preferred providers	Not applicable with non-preferred providers
Deductible	$0	$0

Blue Shield of California — Active Start Plan 35 Generic Rx

A comparison of the Active Start Plan 35 Generic Rx offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: $35	Office Visits: 50%
Copay	$35 with preferred providers	Not applicable with non-preferred providers
Deductible	$0	$0

Blue Shield of California — Balance Plan 1000

A comparison of the Balance Plan 1000 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% with preferred providers	50% with non-preferred providers
Office Visit	Office Visit: $30	Office Visit: 50%
Copay	$30 with preferred providers	Not applicable with non-preferred providers
Deductible	$1,000 ($2,000 family)	$1,000 ($2,000 family)

Blue Shield of California — Balance Plan 1700

A comparison of the Balance Plan 1700 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% with preferred providers	50% with non-preferred providers
Office Visit	Office Visit: $30	Office Visit: 50%
Copay	$30 with preferred providers	Not applicable with non-preferred providers
Deductible	$1,700 ($3,400 family)	$1,700 ($3,400 family)

Blue Shield of California — Balance Plan 2500

A comparison of the Balance Plan 2500 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% with preferred providers	50% with non-preferred providers
Office Visit	Office Visit: $30	Office Visit: 50%
Copay	$30 with preferred providers	Not applicable with non-preferred providers
Deductible	$2,500 ($5,000 family)	$2,500 ($5,000 family)

Blue Shield of California — BS Life PPO 1500

A comparison of the BS Life PPO 1500 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: $40	Office Visits: 50%
Copay	$40 with preferred providers	Not applicable with non-preferred providers
Deductible	$1,500 ($3,000 family)	$1,500 ($3,000 family)

Blue Shield of California — BS Life PPO 2000

A comparison of the BS Life PPO 2000 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: $45	Office Visits: 50%
Copay	$45 with preferred providers	Not applicable with non-preferred providers
Deductible	$2,000 ($4,000 family)	$2,000 ($4,000 family)

Blue Shield of California — Essential Plan 1750

A comparison of the Essential Plan 1750 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	Office Visits (first 3 visits/calendar year - subsequent visits are subject to the deductible): $40 (No charge after deductible)	Office Visits (first 3 visits/calendar year - subsequent visits are subject to the deductible): 50%
Copay	$40 with preferred providers	Not applicable with non-preferred providers
Deductible	$1,750	$1,750

Blue Shield of California — Essential Plan 3000

A comparison of the Essential Plan 3000 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	Office Visits (first 3 visits/calendar year - subsequent visits are subject to the deductible): $40 (No charge after deductible)	Office Visits (first 3 visits/calendar year - subsequent visits are subject to the deductible): 50%
Copay	$40 with preferred providers	Not applicable with non-preferred providers
Deductible	$3,000	$3,000

Blue Shield of California — Essential Plan 4500

A comparison of the Essential Plan 4500 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	100%	50%
Office Visit	Office Visits (first 3 visits/calendar year - subsequent visits are subject to the deductible): $40 (No charge after deductible)	Office Visits (first 3 visits/calendar year - subsequent visits are subject to the deductible): 50%
Copay	$40 with preferred providers	Not applicable with non-preferred providers
Deductible	$4,500	$4,500

Blue Shield of California — Shield Spectrum PPO Savings Plan 3500

A comparison of the Shield Spectrum PPO Savings Plan 3500 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	No charge after deductible with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: No charge after deductible	Office Visits: 50%
Copay	see brochure	see brochure
Deductible	Services with preferred providers: $3,500 ($7,000 family)	Services with non-preferred providers: $5,000 ($10,000 family)

Blue Shield of California — Shield Spectrum PPO Savings Plan 5200

A comparison of the Shield Spectrum PPO Savings Plan 5200 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	No charge after deductible with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: No charge after deductible	Office Visits: 50% after deductible
Copay	N/A	N/A
Deductible	Services with preferred providers: $5,200 ($10,400 family)	Services with non-preferred providers: $5,200 ($10,400 family)

Blue Shield of California — Shield Spectrum PPO 1500

A comparison of the Shield Spectrum PPO 1500 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: $40	Office Visits: 50%
Copay	$40 with preferred providers	Not applicable with non-preferred providers
Deductible	$1,500 ($3,000 family)	$1,500 ($3,000 family)

Blue Shield of California — Shield Spectrum PPO 2000

A comparison of the Shield Spectrum PPO 2000 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% with preferred providers	50% with non-preferred providers
Office Visit	Office Visit: $45	Office Visits: 50%
Copay	$45 with preferred providers	Not applicable with non-preferred providers
Deductible	$2,000 ($4,000 family)	$2,000 ($4,000 family)

Blue Shield of California — Shield Spectrum PPO 500

A comparison of the Shield Spectrum PPO 500 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	75% with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: $30	Office Visits: 50%
Copay	$30 with preferred providers	Not applicable with non-preferred providers
Deductible	$500 ($1,000 family)	$500 ($1,000 family)

Blue Shield of California — Shield Spectrum PPO 5000

A comparison of the Shield Spectrum PPO 5000 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: $35	Office Visits: 50%
Copay	$35 with preferred providers	Not applicable with non-preferred providers
Deductible	$5,000 ($10,000 family)	$5,000 ($10,000 family)

Blue Shield of California — Shield Spectrum PPO 750

A comparison of the Shield Spectrum PPO 750 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% with preferred providers	50% with non-preferred providers
Office Visit	Office Visits: $35	Office Visits: 50%
Copay	$35 with preferred providers	Not applicable with non-preferred providers
Deductible	$750 ($1,500 family)	$750 ($1,500 family)

Blue Shield of California — Shield Spectrum PPO Savings Plan 1800

A comparison of the Shield Spectrum PPO Savings Plan 1800 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% at preferred providers	50% at non-preferred providers
Office Visit	Office Visits: $35 after deductible	Office Visits: 50% after deductible
Copay	$35 after deductible	50% after deductible
Deductible	$1,800 ($3,600 family)	$1,800 ($3,600 family)

Blue Shield of California — Shield Spectrum PPO Savings Plan 2400

A comparison of the Shield Spectrum PPO Savings Plan 2400 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	70% at preferred providers	50% at non-preferred providers
Office Visit	Office Visits: $35 after deductible	Office Visits: 50% after deductible
Copay	$35 after deductible	50% after deductible
Deductible	$2,400 ($4,800 family)	$2,400 ($4,800 family)

Blue Shield of California — Shield Spectrum PPO Savings Plan 4000

A comparison of the Shield Spectrum PPO Savings Plan 4000 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	No charge after deductible at preferred providers	50% with non-preferred providers
Office Visit	Office Visits: No charge after deductible	Office Visits: 50% after deductible
Copay	N/A	N/A
Deductible	Services with preferred providers: $4,000 ($8,000 family)	Services with non-preferred providers: $5,000 ($10,000 family)

Blue Shield of California — Vital Shield 2900

A comparison of the Vital Shield 2900 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers	50% with non-preferred providers
Office Visit	First 2 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum: $40	No charge after copay maximum
Copay	First 2 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum: $40	No charge after copay maximum
Deductible	$2,900	$2,900

Blue Shield of California — Vital Shield 900

A comparison of the Vital Shield 900 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers	50% with non-preferred providers
Office Visit	First 2 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum: $40	No charge after copay maximum
Copay	First 2 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum: $40	No charge after copay maximum
Deductible	$900	$900

Blue Shield of California — Vital Shield Plus 2900

A comparison of the Vital Shield Plus 2900 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers	50% with non-preferred providers
Office Visit	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): $30	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): No charge after copay maximum
Copay	$30 with preferred providers	Not applicable with non-preferred providers
Deductible	Services with preferred providers: $2,900 ($5,800 family)	Services with non-preferred providers: $5,000 ($10,000)

Blue Shield of California — Vital Shield Plus 2900 Generic Rx

A comparison of the Vital Shield Plus 2900 Generic Rx offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers	50% with non-preferred providers
Office Visit	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): $30	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): No charge after copay maximum
Copay	$30 with preferred providers	Not applicable with non-preferred providers
Deductible	Services with preferred providers: $2,900 ($5,800 family)	Services with non-preferred providers: $5,000 ($10,000)

Blue Shield of California — Vital Shield Plus 400

A comparison of the Vital Shield Plus 400 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers.	50% with non-preferred providers.
Office Visit	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): $30	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): No charge after copay maximum
Copay	$30 with preferred providers	Not applicable with non-preferred providers
Deductible	Services with preferred providers: $400 ($800 family)	Services with non-preferred providers: $5,000 ($10,000 family)

Blue Shield of California — Vital Shield Plus 400 Generic Rx

A comparison of the Vital Shield Plus 400 Generic Rx offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers	50% with non-preferred providers
Office Visit	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): $30	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): No charge after copay maximum
Copay	$30 with preferred providers	Not applicable with non-preferred providers
Deductible	Services with preferred providers: $400 ($800 family)	Services with non-preferred providers: $5,000 ($10,000 family)

Blue Shield of California — Vital Shield Plus 900

A comparison of the Vital Shield Plus 900 offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers	50% with non-preferred providers
Office Visit	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): $30	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): No charge after copay maximum
Copay	$30 with preferred providers	Not applicable with non-preferred providers
Deductible	Services with preferred providers: $900 ($1,800 family)	Services with non-preferred providers: $5,000 ($10,000 family)

Blue Shield of California — Vital Shield Plus 900 Generic Rx

A comparison of the Vital Shield Plus 900 Generic Rx offered by Blue Shield of California is detailed out below for both Network and Non-Network coverage.

	Network	Non-Network
Network	See Provider	See Provider
Coinsurance	60% with preferred providers	50% with non-preferred providers.
Office Visit	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): $30	First 5 visits/calendar year for any combination of preventive care and physician office visits - subsequent visits are subject to the copayment maximum): No charge after copay maximum
Copay	$30 with preferred providers	Not applicable with non-preferred providers
Deductible	Services with preferred providers: $900 ($1,800 family)	Services with non-preferred providers: $5,000 ($10,000 family)