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Comparing Premier PPO $20 Copay And Premier PPO $10 Copay |
Premier plans offer by Blue Cross of California offer some of the most generous benefits and provide immediate benefits for doctor visits and prescription drugs. They also offer comprehensive coverage for out of network services.
The Premier PPO $20 Copay plan and the Premier PPO $10 Copay plan both offer a low annual deductible of just $250 with a two-member maximum. This means that when two members of the same enrolled family reach the $250 deductible it is waived for all remaining members of the family.
The annual maximum out-of-pocket expense for Premier PPO $20 Copay plan members of $3,000 per member and will be considered satisfied for all enrolled family members once two members have reached the maximum limit annually. For out of network services, the deductible is $5,000 per person.
For members of the Premier PPO $10 Copay plan, the maximum out-of-pocket costs is $2,500 per member, with a two member maximum applying and a $5,000 maximum per member for out of network service costs. Again, two members meeting the maximum satisfy the expense for all other plan members.
Professional services ordered by a physician such as X-ray, diagnostic testing and maternity, is charged at 20 percent of negotiated fees for Premier PPO $20 Copay plan members and inpatient and outpatient hospital services are 20 percent of any negotiated fees. Professional services for members of the Premier PPO $10 Copay plan are charged 10 percent of negotiated fees for professional services and 10 percent of negotiated fees for all hospital services.
Prescription drugs are not subject to the annual deductible and the Premier PPO $20 Copay plan contains a $15 copay for generic drugs and a $25 copay for name brand drugs. For self-administered injectable drugs, except insulin, there will be a charge of 30 percent of the negotiated fee. There is a $10 copay for generic drugs for member of the Premier PPO $10 Copay plan and $20 copay for name brand drugs and the same 30 percent of negotiated fees for self-administered injectable drugs except insulin. Members can choose a name brand drug even if a generic equivalent is available if the doctor writes the prescription as dispense as written or do not substitute.
Screenings for members age seven through adult, Well Baby immunizations and other preventive medicine testing will be $20 office visit copay plus 20 percent of negotiated fees for other covered services for members of the Premier PPO $20 Copay plan and for members of the Premier PPO $10 Copay plan it will be the $10 office copay and 10 percent of the negotiated fees for all other covered services.
Both plans offer Health Check screenings at $25 for the basic screening and $75 for the premium screening or a physical exam is covered through the $20 copay plus 20 percent of the negotiated fee in the Premier PPO $20 Copay plan. Under the Premier PPO $10 copay plan the fee is the $10 office visit copay plus 20 percent of the negotiated fees for all other services.
Learn more at: www.baahealth.com
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