How to Know Which Blue Cross of California Plan is Right for you

Blue Cross of California is part of largest health insurance provider in the nation. It 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. There is a reason why Blue Cross is the largest in California. What you will find is coverage options that are easy to understand, health plans to fit everyone’s budget, customer service that is always there to answer your questions and one of the largest networks of doctors and hospitals. Blue Cross of California offers four group of health plans, your standard PPO plans, HMO health plans, Lumenos Plans and Short Term Health Plans.

Preferred Provider Organization plans — PPO plans for short — save you money when you use healthcare providers within a selected network. Blue Cross has one of the largest PPO networks in California, with over 48,500 doctors and 465 hospitals.
By putting together this network of healthcare professionals, Blue Cross is able to ensure the quality of healthcare services its members receive. It’s also able to negotiate the price those services will be given at — enabling it to pass savings on to its members.

These plans are ideal for people with a family — or people about to start one. They offer coverage for you and your school-age children. They also offer maternity benefits.

Best of all, most of the services you and your family need immediately are covered before you have to start paying the deductible. This includes preventive care, doctor visits, and generic prescription drugs.

Some of the features of Blue Cross PPO plans include:
• $10 copay on prescription drugs
• Maternity coverage
• Flexible deductible options — as low as $500
• Coverage for physical therapy and acupuncture
• Coverage for “Well Baby” and “Well Child” care

The flexible deductible helps you budget for your medical needs. The higher the deductible you choose, the lower your monthly premiums.

Like most PPO plans, the Blue Cross plans let you use a healthcare provider outside of the network, and still enjoy some coverage. For most services, Blue Cross will still pay up to 50% of the cost of healthcare you receive outside the network. But to get full coverage, you should choose a provider within the network. Blue Cross has a provider finder to help you find a professional in your area.

Health Maintenance Organization plans — HMO plans for short — offer affordable coverage with predictable expenses.
HMO plans are able to offer affordable healthcare by controlling the costs of elective care. In an HMO plan, your healthcare is organized by a primary care physician. This physician is responsible for your routine care and exams, and refers you to specialists when needed. HMO plans are cheaper than PPO plans, but have a smaller network of healthcare providers.

To take advantage of the coverage, you have to use providers within the plan’s network. This can be an inconvenience if your current doctor isn’t part of the network. But since Blue Cross has one of the largest networks in California, finding a healthcare provider is easy. Blue Cross even has a Provider Finder to help you locate a healthcare professional near you.

Blue Cross HMO plans have low deductibles. And some of the plans have no deductible. Doctor visits have copayments as low as $10. And generic drugs only cost $10 a prescription, too.

Other HMO benefits:
• 80% coverage of inpatient hospital fees
• Maternity coverage — only a $10 copay for doctor visits
• Coverage for physical therapy and chiropractic services
• No charge for x-rays and anesthesia when related to a doctor’s visit

Because of the controlled costs, budgeting for your healthcare needs is easy. And if you choose an HMO plan with no deductible, you don’t have to pay out for your coverage to kick in.

While HMO plans aren’t as flexible as PPO plans, the savings and the predictability of expenses are worth it for most people and families. And if you or someone in your family has a pre-existing condition, an HMO plan could be your best option.
The new Lumenos plans from Blue Cross of California give you control over your healthcare. That means you control where your healthcare dollars go. Nothing comes between you and your doctor. And with the Lumenos Health Incentive Account plan, Blue Cross will actually reward you for making healthy decisions.

Lumenos is a consumer-directed health plan. That means that instead of relying on your insurance company to make health decisions for you, you and your doctor are in control of your healthcare.

Once you meet your deductible, the Lumenos plans include 100% coverage for many healthcare needs, including visits to your doctor, inpatient hospital services, prescription drugs, and maternity care.

And like all health plans from Blue Cross of California, the Lumenos plans include access to the award-winning Blue Cross health management website. If you have health questions, the Nurse Advice Line is just a phone call away — and available 24 hours day. And the Personal Health Coach Program will give you assistance managing your special health needs.