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Comparing PPO $30 Copay & Advantage PPO $25 Copay |
Blue Cross of California offers a variety of Preferred Provider Organization, or PPO, plans to fit the needs of their members. PPO plans are excellent for people who have ever wished they had a little more control of their health care, as they are able to choose the physician of their choice from a list of covered providers.
The $30 co pay PPO and the Advantage PPO with the $25 co pay from Blue Cross of California do share a lot of the same features. For example, both PPO plans cover twelve doctor office visits per calendar year and the plan pays 55 percent of the cost of visits above and beyond those twelve. Both plans also pay 70 percent of costs related to hospital stays, and both plans require $15 co pays for generic drugs and $25 co pays for name brand prescription drugs. In addition to the similarities between prescription drug co pays, PPO plan members are able to choose a service level for their annual HealthyCheck exams.
In spite of all the similarities between the $30 co pay PPO option and the $25 Advantage PPO options, there are a number of differences that could weigh in the final decision between the plan that best fits your needs. First off, the annual deductible for the $30 co pay option is $500 per year (excluding doctor’s office visits) whereas the $25 co pay Advantage PPO carries with it a $250 annual deductible, which also excludes doctor’s office co pays.
The Advantage PPO also has a lower out of pocket maximum than the $30 co pay option--the Advantage plan has an annual out of pocket maximum of $3600, whereas the $30 co pay PPO has an annual maximum of $4000. The out of pocket maximum is the amount that plan members are allowed or required to pay out of their own money before the plan kicks in and begins covering the remaining of their medical expenses for that year.
Another major difference between these two plans is that with the $30 co pay option, annual physical exams are on the list of medical expenses that are not covered by the plan. On the PPO Advantage plan, members can choose between the HealthyCheck exam (for adults and children above 7 years of age) and an annual physical exam. Well Baby check ups or regular physical exams apply for children who have not yet satisfied the age requirement for a HealthyCheck exam.
Of course, the main difference between the Advantage PPO and the $30 co pay option is the difference in price. The lower the co pay, the higher the monthly premium, not to say that with Blue Cross PPO plans you don’t get what you pay for. The more basic the plan, the less it costs the member, but for those who have more complicated health care needs, have medical conditions or get sick more often the more advanced PPO plans may be the most suitable for such needs.
Learn more at: www.baahealth.com
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