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Out Of Network Options Available In PPO $35 Copay Genrx |
As companies and subscribers push for more benefits from their premium payments, Blue Cross of California continually strives to help them meet that goal. The PPO $35 Copay GenRX offers superb returns on the premium investment.
Plans by Blue Cross negotiate with health care providers to achieve the lowest possible costs for services. From office visits and hospital care to prescription drugs, the negotiated fees for in network care is always lower than fees charged by providers outside the network.
There is a $500 per member deductible which will be considered satisfied for all remaining enrolled family members once two plan members reach that amount of their deductible. Deductibles are waved for office visits, HealthyCheck Screening and prescription drug co-payments. Payment of the deductible also applies towards the annual out-of-pocket maximum amount.
The annual maximum out-of-pocket ceiling is $4,000 per member, with two members meeting the maximum satisfies the maximum for all other enrolled family members in the plan and includes the annual deductible. Out of network health care services have a maximum allowance of $10,000 per member.
For initial office visits, there will be a $35 copay for the first 12 visits per member. Additional visits will cost 45 percent of the negotiated fee. For out of network doctor’s office visits, the fee will be 50 percent of the negotiated fee plus 100 percent of excess charges.
For professional services such as X-ray, diagnostic test and surgeon services will be 35 percent of the negotiated fee for in network provider. For services rendered by providers outside the network the member will pay 50 percent of the negotiated fee plus 100 percent of any excess charges. Hospital services, inpatient or outpatient will be charged at 35 percent of the negotiated fee.
For prescription benefits, there is $15 copay for generic drugs and 30 percent of the negotiated price for self-administered injectable drugs. For members who wish to purchase name brand drugs can present their membership cards to a network pharmacy.
Preventive health care is available for a $35 office visit copay, not subject to the deductible plus 335 percent of the negotiated cost for all other covered services. HealthyCheck screening is available for a $25 copay for the basic screening and $75 copay for superior screening. There is no coverage in this plan for an annual physical exam.
Learn more at: www.baahealth.com
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