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Blue Shield Saver 4000 & 6000 (HSA Compatible)

Benefits: Shield Saver 6000 - (HSA Compatible) Shield Saver 4000 - (HSA Compatible) Annual Deductible In Individual: $6,000 Family: $12,000 (embedded; See Brochure) Individual: $4,000 Family: $8,000 (embedded; See Brochure) Out Individual: $12,000 Family: $24,000 (embedded; See Brochure) Individual: $8,000 Family: $16,000 (embedded; See Brochure) Out of Pocket Maximum In Individual: $6,000 Family: $12,000 Individual: $4,000 Family: $8,000 Out Individual: $18,000 Family: $36,000 Individual: $14,000 Family: $28,000 Lifetime Maximum In None None Out None None Outpatient Benefits: Shield Saver 6000 Shield Saver 4000 Doctors' Office Visits In No Charge after Deductible No Charge after Deductible Out 50% 50% X-ray and laboratory In No Charge after Deductible No Charge after Deductible Out 50% 50% Rx Copay/Coinsurance In No Charge after Medical/Rx Deductible No Charge after Medical/Rx 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 No Charge after Deductible No Charge after Deductible Out No Charge after Deductible No Charge after Deductible Ambulance Services In No Charge after Deductible No Charge after Deductible Out No Charge after Deductible No Charge after Deductible Outpatient Surgery In No Charge after Deductible No Charge after Deductible Out 50% 50% Inpatient Hospital Benefits: Shield Saver 6000 Shield Saver 4000 Inpatient Hospital In No Charge after Deductible No Charge after Deductible Out 50% 50% Chemical Dependency Services In No Charge after Deductible No Charge after Deductible Out 50% 50% Maternity In No Charge after Deductible No Charge after Deductible Out 50% 50% Home Health Care In No Charge after Deductible (90 visits per year) No Charge after Deductible (90 visits per year) Out Not Covered Not Covered Other Benefits: Shield Saver 6000 Shield Saver 4000 Mental Health - Outpatient In No Charge after Deductible (20 visits per year) No Charge after Deductible (20 visits per year) Out Not Covered Not Covered Mental Health - Inpatient In No Charge after Deductible No Charge after Deductible Out 50% 50% Chiropractic care In No Charge after Deductible (12 visits / year, pays up tp $25 /visit, see brochure) No Charge after Deductible (12 visits per year, pays a maximum of $25 per visit, see brochure) Out Not Covered Not Covered Acupuncture In No Charge after Deductible (12 visits / year, pays up tp $25 /visit, see brochure) No Charge after Deductible (12 visits / year, pays up tp $25 /visit, see brochure) Out No Charge after Deductible (12 visits / year, pays up tp $25 /visit, see brochure) No Charge after Deductible (12 visits / year, pays up tp $25 /visit, see brochure) Exclusions and Limitations

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.

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