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Blue Cross Of California HMO Plans--Power Select HMO Plan |
Blue Cross of California has four options for members who prefer the convenience of Health Maintenance Organizations, more commonly referred to as HMOs. HMOs are great for large families or parents with children. In an HMO a Primary Care Physician (PCP) is chosen for all customary medical needs. Out of pocket costs are scheduled with HMOs, making it a much better option for members on a budget.
The Power Select HMO option is reputed to be Blue Cross of California’s most affordable HMO option. It provides the most basic coverage of the four options. The annual deductible for the Power Select HMO is $500 per member and it applies toward the out of pocket maximum of $2,250 per individual member and $4, 500 for a family, no matter how many members are included on the plan. The annual deductible applies to in-patient and out patient hospital visits and dialysis, but not towards Emergency Room visits.
Members of the Power Select HMO plan always visit the same doctor for their regular office visits. Such visits require a $25 co pay for the primary care physician. If for some reason a member’s primary care physician must refer the member to a specialist, the co pay increases ten dollars to $35. These expenses are not subject to a deductible. For the PowerSelect HMO, visits to non-participating physicians--for any reason--is a non-covered expense.
Blue Cross of California’s Power Select HMO option provides coverage for inpatient as well as outpatient visits to participating hospitals. For charges for inpatient hospital services, the member is only required to pay ten percent of the total bill, leaving the HMO to cover the remaining ninety percent. For outpatient hospital services, the member is required to pay twenty percent of the charges incurred, and the plan will kick in and pay the remaining eighty percent of the bill.
Professional services (such as expenses related to pregnancy, lab work and the like) are completely covered by the HMO, except for visits to the doctor related to maternity, which only requires the $25 co pay for the visit to the doctor’s office.
The Power Select HMO does carry with it a $150 annual deductible for name brand prescription drugs. The co pay for name brand prescription drugs is $25. For generic prescription drugs, the co pay is $15. The HMO also covers 70 percent of the cost of all self inject able drugs (except insulin) leaving the member to cover the remaining 30 percent. This remaining cost to the member does of course count toward the out of pocket maximum.
The Power Select HMO option from Blue Cross of California serves 22 counties in the state of California. Participating physicians (providers who are considered to be “in-network”) are of these 22 counties. This HMO plan cannot be offered in conjunction with any other HMO plans that Blue Cross of California offers.
Learn more at: www.baahealth.com
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