Blue Shield of California Oleg Skurskiy (818) 654-4548  

Authorized Agent for Blue Shield of California


  Blue Shield PPO Blue Shield HMO Blue Shield Senior
Applications Provider Finder Members  
 

Blue Shield of California

Spectrum PPO Plan 5000 & 5500
 

Get a Quote

 Apply now
Benefits:
Shield Spectrum 5000
Shield Spectrum 5500
Annual Deductible
In
Individual: $5,000 Family: $10,000
Individual: $5,500 Family: $11,000
Out
Individual: $5,000 Family: $10,000
Individual: $5,500 Family: $11,000
Out of Pocket Maximum
In
Individual: $7,000 Family: $14,000
Individual: $7,500 Family: $15,000
Out
Individual: $10,000 Family: $20,000
Individual: $10,000 Family: $20,000
Lifetime Maximum
In
Unlimited
Unlimited
Out
Unlimited
Unlimited
Outpatient Benefits:
Shield Spectrum 5000
Shield Spectrum 5500
Doctors' Office Visits
In
$35 after Deductible
35%
Out
50%
50%
X-ray and laboratory
In
30%
35%
Out
50%
50%
Rx Copay/Coinsurance
In
Generic: $10 Brand Formulary: $35 Brand Non-Formulary $50 or 50%, whichever is greater ($500 Brand Deductible)
Generic: $10 Brand Formulary: $45 Brand Non-Formulary $60 or 50%, whichever is greater ($750 Brand Deductible)
Out
Not Covered
Not Covered
Annual Physical Exam
In
No Charge
No Charge
Out
Not Covered
Not Covered
Annual Routine Gyn Exam
In
No Charge
No Charge
Out
Not Covered
Not Covered
Well Baby Care
In
No Charge
No Charge
Out
Not Covered
Not Covered
Emergency Room Services
In
30%
$100 per visit (waived if admitted) then 35%
Out
30%
$100 per visit (waived if admitted) then 35%
Ambulance Services
In
30%
35%
Out
30%
35%
Outpatient Surgery
In
30%
35%
Out
50%
50%
Inpatient Hospital Benefits:
Shield Spectrum 5000
Shield Spectrum 5500
Inpatient Hospital
In
30%
35%
Out
50%
50%
Chemical Dependency Services
In
30%
35%
Out
50%
50%
Maternity
In
30%
35%
Out
50%
50%
Home Health Care
In
30% (90 visits per year)
35% (90 visits per year)
Out
Not Covered
Not Covered
Other Benefits:
Shield Spectrum 5000
Shield Spectrum 5500
Mental Health - Outpatient
In
30% (20 visits per year)
35% (20 visits per year)
Out
Not Covered
Not Covered
Mental Health - Inpatient
In
30%
35%
Out
50%
50%
Chiropractic care
In
Not Covered
Not Covered
Out
Not Covered
Not Covered
Acupuncture
In
Not Covered
Not Covered
Out
Not Covered
Not Covered

All Blue Shield of California health plans

Access®+ Value HMO
Access®+ HMO
 
Blue Shield Senior
 
Blue Shield Short Term
 
 

 

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
Site Map
Copyright © 2005 Oleg Skurskiy Authorized Independent Agent, CA License 0E50389