| |
RightPlan PPO 40 May Be Right For You |
Health care costs have been escalating for the past several years and there is no sign of any abatement in the near future. Flexible plans put together by Blue Cross of California have some of the lowest premiums available with some of the better coverage to help keep your costs lower.
Additionally all costs included in the plan have been negotiated with the network of providers, doctor, hospitals and pharmacies, to insure the lowest prices possible. In network healthcare providers will accept the negotiated fee as payment in full for negotiated services.
The RightPlan PPO 40 offers one of the most flexible prescription plans available with three levels of drug coverage available. Under the RightPlan 40 the first plan, P958 offers no drug coverage while the PE48 $10 generic copay for drugs on generic prescription formula only. Better prescription coverage is available in the RightPlan 40 PE49 that offers Blue Cross formulary drugs with a $10 generic copay and a $30 brand name copay after a $500 brand name deductible has been met.
If a member chooses a name brand drug when a generic drug is available, they will be charged for the generic copay along with the difference in cost of the generic drug and the name brand drug, even if the doctor writes do not substitute or dispense as written on the prescription. Self-administered injectable drugs will be charged at 30 percent of the negotiated price. Copays shown for drugs are for a 30-day supply whether through retail or mail in services.
With the RightPlan PPO 40 there is no annual deductible, however there is a $7,500 per member maximum out-of-pocket expense. Expenses incurred through provider and non-participating providers covered services apply towards the annual maximum out-of-pocket expense.
There is a $40 copay for doctor’s visits and for professional services such as X-ray, diagnostic laboratory tests and anesthesia ordered by the physician; the cost is 40 percent of the negotiated fee. There is no coverage for maternity care.
For hospital care, inpatient or outpatient, the fee is 40 percent of negotiated fees plus a $500 copay. For the RightPlan PPO 40 the copay is per day with a four-day maximum per each admission. For outpatient services the $500 copay is per each surgical admission.
For preventive health care, members can receive a basic health screening at HealthyCheck centers for $25 and a premium screening for $75. Routine tests such as a mammogram, Pap test and PSA order by a physician is charged a $40 office visit copay as well as 40 percent of the negotiated fee. Well Child care is $40 office visit copay plus 40 percent of the negotiated fee.
Learn more at: www.baahealth.com
|
