Blue Shield of California

Blue Shield of California Life & Health Insurance Company Life has grown by offering competitive insurance products including Group Term Life, Accidental Death & Dismemberment, Blue Shield of California Life & Health Insurance Company Life Vision Plan, Stop Loss and Exec-U-Med medical reimbursement plans in tandem with Blue Shield of California health plans or on a stand-alone basis . In the early 1980s, introduced their Short-Term Health products. The Option One and Option Twelve plans remain one of the leading products of their kind in California.

Without health coverage, you could pay an average of $9,328 a day in the hospital. It's very important to get the protection you need. Getting the right health insurance can be one of the most important things you can do.  Various plans and pricing is the most confusing aspect of the individual health insurance market. Understanding Insurance and choosing an appropriate policy for your specific needs can be complicated. There are many plans, various coverage’s, options and restrictions. Deciding on a policy that best suits your needs is not always easy. For instance, the premiums for similar products from different insurers can vary by as much as 50 percent for the same person.  The deductible and coverage is a balancing act depending on each plan and each company and price.  Our dedicated agency gives you the advantage of One-stop shopping. You get to shop and compare health insurance rates and benefits with all the major plans in California. This saves you time and money, with the benefit of always speaking with an agent right away.

Active Start Plans: If you aren't planning a family (or want to have more children), why pay ofr benefits you may not want, like maternity? This popular plan give yous a variety of choices and rich benefit levels - and affordable monthly premiums. Features immediate, no-medical deductible benefits and prescription drug options. Blue Shield's individual coverage plans combine no medical deductible and relatively low premiums into an economical PPO health plan. Active Start is ideal for individuals looking for health coverage that covers you in case of a potentially expensive medical event, while also taking care of your day-to-day healthcare needs. If you are considering health coverage for the first time, you may be particularly interested in one of Blue Shield's Active Start Plans.

With no medical deductible, your healthcare coverage is working for you from the start. And low copayments for generic prescription drugs and preventive care means you can seek medical attention before a small concern grows into a large problem.

Plan Features:

Affordable healthcare coverage for individuals (Active Start Plans do not include options for two-party and family coverage, nor coverage for maternity care.)

No medical deductible, so your coverage starts immediately $25 or $35 copayments for preventive care and office visits; $10 copayments for generic prescription drugs at participating pharmacies

Alternative care benefits for acupuncture and chiropractic services

Access to one of California's largest PPO preferred provider networks

Essential Plans

Blue Shield of California's individual-only plan offerings include three PPOs: Essential Plan 1750, 3000 and 4500.

These plans minimize your annual out-of-pocket costs and offer quality coverage, including dental and vision. They are ideal for individuals who don't need expensive full coverage that includes maternity and brand-name drugs. Plan Features Comprehensive coverage - includes medical, dental and vision care.

Benefits of Essential Plans:

Affordable monthly rates

Manageable out-of-pocket medical costs

- Your copay maximum equals the deductible for participating providers

- You're covered at 100 percent for services from participating providers after the deductible is met

Affordable copayments

- Preventive care office visits ($40)(for the first 3 visits per calender year only)

- Generic prescription drugs at network pharmacies ($10)

Choice of three deductibles: $1750, $3000 or $4500

Available for individuals only Access to one of the largest provider networks in California, so it's easy to find the doctor you want

Balance Plans

This is one of Blue Shield's of California's newest individual and family plan's. Blue Shield of California's newest PPO plan family balances coverage and cost, and offers a sensible blend of comprehensive benefits and relatively low deductibles:

BalanceSM Plan 2500, BalanceSM Plan 1700 and Balance Plan 1000

These plans provide coverage for preventive care, doctor's office visits, generic prescription coverage and ER care right away, before you meet your deductible.

Balance plan advantages:

Choice of three deductibles: $2,500, $1,700 or $1,000

The plan's copayment/coinsurance maximum includes your medical deductible, so you'll pay only up to the copayment/coinsurance maximum in a calendar year

Doctor's office visits and preventive care are provided for a fixed copay ($30) before you need to meet the deductible

Generic drugs for $10

One of California's largest PPO networks, so it's easy to find doctors and hospitals Includes benefits for chiropractic care and acupuncture

Blue Cross of California Info

Blue Cross of California has been serving the health care needs of Californians since 1937. Blue Cross of California, together with its branded affiliates, provides health care services to more than 6.8 million members. Offering a full continuum of product and coverage options, Blue Cross provides customers with unparalleled choice and flexibility in meeting their health plan needs. These options are continually fine-tuned to enhance access to affordable, quality health care. The Company, with its strong track record for innovation, focuses on progressive products and services designed to improve the health status of all Californians. Unique product offerings available in the individual, small group, large group, senior and Medi-Cal markets include a full range of integrated medical and specialty products. Blue Cross has been supporting California lifestyles for decades - and they look forward to supporting yours.

Blue Cross of California is committed to improving health care for all of us. For over 60 years Blue Cross has been addressing changes in the healthcare system and making sure Californians can get the care they need at a price they can afford. From their vast doctor network to alternative medicine coverage to personalized plans, toll-free help lines and member focused services, Blue Cross is California's leading healthcare company. Blue Cross of California offers a broad range of health plans.

Benefits of Blue Cross:

Online Services: Blue Cross of CA's web site continues to offer more information about all Blue Cross of California products and services. It now features interactive web pages so members may communicate electronically with Customer Service for ID card replacement or benefit issues, as well as receive online information about claim status, eligibility and family enrollment, or download claim forms and EOBs.

Access to the nation's largest provider network when traveling or temporarily living outside California.

Emergency care coverage anywhere in the world, 24-hours a day, seven-days a week.

Enhanced member services that provide discounts to alternative health care practitioners, products and services.

Toll-free number to Customer Service with option to speak to a Customer Service representative or get answers fast from their automated information system.

Blue Cross of California Health Insurance Plans

Tonik health insurance plans are designed by-and for-''young invincibles,'' as an effort to expand access to health care coverage for one of the fastest growing uninsured populations in the state and the country. Tonik plans are simple, easy to use and affordable. Tonik covers everyday preventive needs (like routine doctor visits) as well as the more serious medical necessities. Unlike other individual policies on the market, seeing a dentist, getting eye exams, glasses and contacts are all-inclusive within the new benefit design. Although these plans are geared towards "young invincibles", these plans are popular with people of all age groups and it's one of Blue Cross of California's top selling plans.

If you're 19-29 years old, rates can be $69-$142 per month, depending on the plan you pick, where you life, your age, and your medical history. Rates are subject to change.

This is a PPO health insurance plan that is very simple; it provides: Health coverage for your body, eyes, teeth. You know, the important stuff. 3 simple health care plans, 1 just your flavor. Apply online, that's it. No catches, no commitments, no wasted time. Sure, paying for health insurance is a pain. But not having it can hurt a lot more. See how much it could cost you. And remember, if you're covered and stay in the Blue Cross PPO network, the most you'll pay is $1,500, $3,000 or $5,000 plus your monthly payment. Health insurance, straight up. Three plans. Same all-around coverage: preventive, emergency, Rx, eyes, teeth. Tonik health insurance plans are designed for individuals that do not need maternity or name brand prescription drug coverage.

''Young adults think of insurance like broccoli,'' said Steve Synott, general manager of Individual Services for Blue Cross of California. ''They know it`s good for them but they don`t have a taste for it yet.'' As a result, many go without it. There are currently an estimated 1.6 million uninsured 19 to 29-year-olds in California. The financial pain of a sports related injury or other unforeseen event can outweigh the physical. Consider the following: an ambulance ride to the hospital is $607; the average cost of a day in the hospital is $7,175; and knee surgery and care is estimated at $48,302. The costs of Tonik plans are painless. They range from $64 to $123 a month, depending upon the plan, the insured`s age and where they live.

In a unique approach to product development, Blue Cross engaged in a ''reverse point-of-view'' philosophy by examining the preferences and lifestyles of uninsured young adults. Blue Cross research indicated that they are interested in health insurance, if it met their needs and was offered at the right price.

The nice thing about Tonik health insurance plans is that they are only available with an online application. No more messy paper applications with this plan. The application process takes about 10 - 15 minutes to complete and then it is sent directly to the underwriting team at Blue Cross of California. If you wish to view more information about Tonik health insurance plans and benefits, please visit: Tonik health insurance information.

What is the difference between HMO and PPO?

Health Maintenance Organization (HMO): An organization that provides a wide range of comprehensive health care services for a specified group at a fixed periodic payment; a prepaid health care plan under which people may enroll by paying a set annual fee. Members then receive all the medical services they need through a group of contracting doctors and hospitals, often with no additional co-payments or fees. Members are generally limited to using providers designated by the HMO.

Advantages of HMO health plans include: Lower out-of-pocket expenses No lifetime maximum Lower office visit copays Lower hospital deductibles Virtually no claim forms.

Advantages of HMO dental plans include: No waiting periods for most services Access to over 8,600 dental care providers No deductibles

Preferred Provider Organization (PPO): A delivery system where providers are under contract to a carrier to provide care at a discount or for a fixed fee, and the health plan provides incentives to patients to use the contracting providers. The PPO does not assume insurance risk, and it does not facilitate the sharing of risk by its covered persons.

Important factors to consider when choosing health insurance:

Deductible amounts: Most insurance policies require you to cover part of your health expenses yourself (your part is called the "deductible"), before the insurance company pays anything. Under some policies the deductible is annual, and you pay only once each year if you use the insurance. Under others, you pay the deductible each time you have an illness or injury. When choosing insurance, you should think carefully about how much you could afford to pay out of your own pocket each time you are sick or injured and weight the deductible against the premium before you decide.

Co-insurance or co-payment:  Usually, even after you have paid the deductible, an insurance policy pays only a percentage of your medical expenses. The policy might pay 80 percent, for example; the remaining 20 percent, for which you are responsible, is called the coinsurance or co-payment. So, if you were injured and incurred $3,000 in medical expenses, a policy with a $400 deductible and 20 percent co-payment would cover $2,080 (80 percent of $2,600).

Generic Prescription Drug (generic drug): Safe, effective and equivalent to brand name medications that may cost considerably less than the brand name medications. Generic drugs must meet the same high standards of quality as brand name drugs and are formulated to have the same effect in the body as the brand name version. Generic drugs often become available when a brand name drug's patent expires.

When leaving a group health insurance plan, it is important to ask the administrator about all of your options before you leave the plan.  If you are in between jobs, you might consider short-term health insurance.

Short-term Health Insurance: Is a just like it's name states, it is intended for a short amount of time, usually from 1 day to up to 3 months. The rates depend on your plan, deductible, age, and the specific number of days of health insurance needed. Most carriers charge per day of health insurance, up to 3 months. Usually this is might make sense for someone that needs short term health insurance that is in between jobs and knows when they will be starting their next job. Depending on the plan and the premium, this might be more affordable than COBRA.

Pre-existing Conditions:  Many insurance policies do not cover pre-existing conditions. If you arrive with a condition that will need medical attention, verify the pre-existing aspect of the policy that you are reviewing.

Lifetime/per-occurrence maximums:  Many insurance policies limit the amount they will pay for any single individual's medical bills or for any specific illness or injury. This amount usually depends on the specific insurance carrier and they do vary. This is important to examine when you are shopping and comparing health insurance plans.

When to get health insurance:  If you don't have health insurance right now, you should seriously consider purchasing it as soon as possible. No one can predict the future--you don't know when you might suffer an accident or become seriously ill. Health insurance can help to protect you against financial ruin. It is important to have health insurance when you are young & healthy and BEFORE you get sick or get hurt. Call us today at 619-889-0889 for a free comparison or quote.  Your health is the most important thing and it's important for you to protect yourself and family from financial disasters.

We offer California residents a full range of Health Insurance choices.  Please call us at 619-889-0889 for a competitive health insurance quote and comparison.   Below are some of the products and services we offer: 

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Please Note: The information contained in this Web site is provided solely as a source of general information and resource. It is a not a statement of contract and coverage may not apply in all areas or circumstances. For a complete description of coverages, always read the insurance policy, including all endorsements.