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These are not all of the available plans, for a complete listing, please call.
Please also see the disclaimer and explanation provided at the bottom of the page! |
PacifiCare HMO HMO 10
DOCTOR: $10 copay.
PRESCRIPTIONS: $10 generic/$25 brand name (brand name
"not-on-the-list" has to be authorized prior).PREVENTIVE:
Dr. visit, you pay $10. PSA, mammogram, pap smear, you pay $10. Well
child Dr. visits, you pay $10. Immunizations you pay $10. Preventive lab
work you pay $10. LAB WORK-REGULAR: no
charge. HOSPITAL: no charge.
OUTPATIENT EMERGENCY ROOM: you pay $50
. MATERNITY-additional $1000
copayment. ANNUAL PLAN MAX YOU COULD PAY: $1,500
(Family is x 3) |
Use "Get Application" button to print an application OR to request one be mailed! |
Cigna HMO Group One
DOCTOR: $15 Copay.PRESCRIPTIONS: $10 generic/$20 brand name (generic & brand name "not-on-the-list" is not covered). PREVENTIVE: Dr. visit, you pay $15. PSA, mammogram, pap smear, you pay $15. Well child Dr. visits, you pay $15. Immunizations you pay $15. Preventive lab work you pay $15. LAB WORK-REGULAR: no charge . HOSPITAL: you pay $150 per day ($750 Max). OUTPATIENT EMERGENCY ROOM: you pay $75. MATERNITY- no additional cost
ANNUAL PLAN MAX YOU COULD PAY: $2,000 (Family is x 2)
Notes: Durable medical equipment is not covered. |
Use "Get Application" button to print an application OR to request one be mailed! |
| Category 2: | $1500 & $2000 Hospital
Deductible - Economical HMO's |
Any $ or % amounts shown are what you would pay - the health plan would cover the rest. |
Blue Cross HMO Saver HMO
DOCTOR: $10 copay.PRESCRIPTIONS: $10 generic "on-the-list"/Special $250 brand name calendar year deductible then:$25 brand name. PREVENTIVE: Dr. visit, you pay $10. PSA, mammogram, pap smear, you pay $10. Well child Dr. visits, you pay $10. Immunizations you pay $10. Preventive lab work you pay $10. LAB WORK-REGULAR: $10 copay. HOSPITAL OUTPATIENT/INPATIENT: $1500 calendar year deductible, then you pay 20% outpatient and no charge inpatient. OUTPATIENT EMERGENCY ROOM: you pay $50 + 20%. MATERNITY-additional $1000 inpatient copayment. ANNUAL PLAN MAX YOU COULD PAY: $2,500 (Family is x 2) |
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Use "Get Application" button to print an application OR to request one be mailed! |
| Accident Medical Coverage Only $25 monthly, Family or Single--Separate Company's Accident Plan--Pays up to $2,000 per ocurrence, plus if hospitalized, extra $150 per day--Fills in your deductible, and or helps pay your copercentage if care is due to an accident! |
Blue Shield HMO Access +
DOCTOR: $10 copay; $30 self-referral to specialist WITHIN Primary Drs. group.PRESCRIPTIONS: $10 generic/$30 brand name "on-the-list" (brand name "not-on-the-list" is not covered). PREVENTIVE: Dr. visit, no charge. PSA, mammogram, pap smear, no charge. Well child Dr. visits, no charge. Immunizations no charge. Preventive lab work no charge. LAB WORK-REGULAR: no charge. HOSPITAL: $1500 calendar year deductible applies to inpatient services and outpatient surgery. Plus outpatient surgery & supplies--$150 copayment for choice providers and $250 copayment for affiliated providers (affiliated providers charges do not count towards the copayment maximum). Hospital outpatient treatment/procedure--$25 copayment for choice providers and $35 for affiliated providers.
OUTPATIENT EMERGENCY ROOM: you pay $50. MATERNITY- no additional cost ANNUAL PLAN MAX YOU COULD PAY: $3,000 (Family is x 2) |
Use "Get Application" button to print an application OR to request one be mailed! |
Health Net HMO HMO 40
DOCTOR: $40 copay. PRESCRIPTIONS: special $100 calendar year deductible then you pay $15 generic/$25 brand name "on-the-list"/$50 brand name "not-on-the-list". PREVENTIVE: Dr. visit, you pay $40. PSA, mammogram, pap smear, you pay $40. Well child Dr. visits, you pay $40. Immunizations you pay $40. Preventive lab work you pay $40. LAB WORK-REGULAR: no charge. HOSPITAL: outpatient surgery-you pay $250; Inpatient hospital-$2,000 calendar year deductible. OUTPATIENT EMERGENCY ROOM: you pay $100. MATERNITY-additional $2000 inpatient copayment. ANNUAL PLAN MAX YOU COULD PAY: $2,500-not counting maternity (Family is x 2)
Notes: Plan not available in Glenn, Monterey, Nevada, or San Luis Obispo counties! |
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Use "Get Application" button to print an application OR to request one be mailed! |
| Accident Medical Coverage Only $25 monthly, Family or Single--Separate Company's Accident Plan--Pays up to $2,000 per ocurrence, plus if hospitalized, extra $150 per day--Fills in your deductible, and or helps pay your copercentage if care is due to an accident! |
| Category 3: | Low Deductible - Economical PPO's 40% |
Any $ or % amounts shown are what you would pay - the health plan would cover the rest. |
Health Net PPO PPO Value 400
DOCTOR: $40 copay.PRESCRIPTIONS: has a $100 special calendar year deductible then you pay $10 generic/$30 brand name (brand name "not-on-the-list" has to be authorized prior). PREVENTIVE: Dr. visit, you pay $80. PSA, mammogram, pap smear, you pay $40. Well child Dr. visits, you pay $40. Immunizations you pay $40. Preventive lab work ($200 max benefit) included in the $80 doctor visit. CHIROPRACTIC: maximum of 12 visits per year are covered--Health Net pays 50% up to $20 benefit--you pay the rest. ACUPUNCTURE: maximum of 12 visits per year are covered--Health Net pays 50% up $25 maximum per visit--you pay the rest.LAB WORK-REGULAR: Once $400 deductible is met, you pay 40%. HOSPITAL:you pay a $400 hospital deductible per admission, plus once $400 calendar year deductible is met, you pay 40% . OUTPATIENT EMERGENCY ROOM: once $400 calendar year deductible is met, you pay $80 + 40%. MATERNITY-not covered. ANNUAL PLAN MAX YOU COULD PAY: $4,500 (Family is x 2) |
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Use "Get Application" button to print an application OR to request one be mailed! |
| Accident Medical Coverage Only $25 monthly, Family or Single--Separate Company's Accident Plan--Pays up to $2,000 per ocurrence, plus if hospitalized, extra $150 per day--Fills in your deductible, and or helps pay your copercentage if care is due to an accident! |
Nationwide PPO Choice Select
DOCTOR: $40 copay. PRESCRIPTIONS: $10 generic/$30 brand name "on-the-list"/50% brand name "not-on-the-list" (but not less than $45). PREVENTIVE: deductible waived--adult $100 max benefit; well child, you pay $40 Dr., 40% preventive lab work. CHIROPRACTIC & ACUPUNCTURE: combined maximum of 12 visits per year are covered--once $250 calendar year deductible is met, you pay all charges over $40 benefit per visit. LAB WORK-REGULAR: once $250 calendar year deductible is met, you pay 40% . HOSPITAL:you pay a $500 copay per per admission, plus once $250 calendar year deductible is met, you pay 40% . OUTPATIENT EMERGENCY ROOM: once $250 calendar year deductible is met, you pay $75 + 40%. MATERNITY-additional $1500 inpatient deductible. ANNUAL PLAN MAX YOU COULD PAY: $5,000 + deductibles (Family is x 2 the annual max & x 3 the deductible)) |
Use "Get Application" button to print an application OR to request one be mailed! |
| Category 4: | $750 calendar year deductible - Economical PPO's |
Any $ or % amounts shown are what you would pay - the health plan would cover the rest. |
Nationwide PPO Choice 45
DOCTOR: $45 copay.PRESCRIPTIONS: $10 generic/$30 brand name "on-the-list"/50% brand name "not-on-the-list" (but not less than $45). PREVENTIVE: deductible waived--$300 max benefit--Dr. visit, you pay $45. PSA, mammogram, pap smear, you pay 25%. Well child Dr. visits, you pay $45. Immunizations you pay $15. Preventive lab work you pay 25%. CHIROPRACTIC & ACUPUNCTURE: combined maximum of 12 visits per year are covered--once $750 calendar year deductible is met, you pay all charges over $40 benefit per visit. LAB WORK-REGULAR: once $750 calendar year deductible is met, you pay 25% .HOSPITAL: once $750 calendar year deductible is met, you pay 25%. OUTPATIENT EMERGENCY ROOM: once $750 calendar year deductible is met, you pay $100 + 25%. MATERNITY-additional $1500 inpatient deductible. ANNUAL PLAN MAX YOU COULD PAY: $4,000 + deductibles (Family is x 2) |
Use "Get Application" button to print an application OR to request one be mailed! |
| Accident Medical Coverage Only $25 monthly, Family or Single--Separate Company's Accident Plan--Pays up to $2,000 per ocurrence, plus if hospitalized, extra $150 per day--Fills in your deductible, and or helps pay your copercentage if care is due to an accident! |
Blue Shield PPO $750 Deductible Plan
DOCTOR: copay $35 choice providers/$45 affiliated providers.PRESCRIPTIONS: $10 generic/Special $250 brand name calendar year deductible then:$30 brand name "on-the-list"/$45 + 10% brand name "not-on-the-list" ($100 maximum copay).PREVENTIVE: deductible waived--Dr. visit, PSA, mammogram, pap smear, you pay $35 for choice providers and $45 for affiliated providers; well child--same. Lab work--Additional $35/$45. CHIROPRACTIC: maximum of 12 visits per year are covered--Blue Shield pays 50% up $25 maximum per visit--you pay the rest. ACUPUNCTURE: not covered. LAB WORK-REGULAR: once $750 calendar year deductible is met, you pay 30% for choice providers and 40% for affiliated providers.HOSPITAL: once $750 calendar year deductible is met,
you pay 30% for choice providers and 40% for affiliated providers For outpatient surgery there is an additional $250 copay for choice providers and a $350 copay for affiliated providers. OUTPATIENT EMERGENCY ROOM: once $750 calendar year deductible is met, you pay 30%. MATERNITY-additional $1000 inpatient deductible. ANNUAL PLAN MAX YOU COULD PAY: $4,000 + deductibles (Family is x 2) |
Use "Get Application" button to print an application OR to request one be mailed! |
| Category 5: | $1500 Deductible - Economical PPO's |
Any $ or % amounts shown are what you would pay - the health plan would cover the rest. |
Blue Cross PPO PPO Share 1,500
DOCTOR: 25% copay, well child 50% Dr. copay.PRESCRIPTIONS: $10 generic; brand name $25 after $250 RX calendar year deductible. PREVENTIVE: deductible waived--At your Dr.: PSA, mammogram, pap smear, you pay 25%; well child, you pay 50%. At the Healthly Check Center: you pay $25 or $75 (expanded) for Dr. exam & preventive lab. CHIROPRACTIC: maximum of 12 visits per year are covered--once $1000 calendar year deductible is met, you pay 25% per visit. ACUPUNCTURE: maximum of 12 visits per year are covered--you pay all charges over $25 per visit. LAB WORK-REGULAR: once $1000 calendar year deductible is met, you pay 25%. HOSPITAL: once $1000 calendar year deductible is met, you pay 25%. OUTPATIENT EMERGENCY ROOM: once $1000 calendar year deductible is met, you pay $30 + 25%. MATERNITY-additional $1000 deductible ANNUAL PLAN MAX YOU COULD PAY: $4,000 (Family is x 2) BUT Brand Name RX and MATERNITY deductbles do not count towards the maximum |
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Use "Get Application" button to print an application OR to request one be mailed! |
| Accident Medical Coverage Only $25 monthly, Family or Single--Separate Company's Accident Plan--Pays up to $2,000 per ocurrence, plus if hospitalized, extra $150 per day--Fills in your deductible, and or helps pay your copercentage if care is due to an accident! |
| Category 6: | $2500 Deductible Economical PPO's |
Any $ or % amounts shown are what you would pay - the health plan would cover the rest. |
Health Net PPO Value PPO Basic 2500
PRESCRIPTIONS: has a $100 special calendar year deductible then you pay $10 generic/$35 brand name (brand name "not-on-the-list" has to be authorized prior). CHIROPRACTIC: not covered. ACUPUNCTURE: not covered. Preventive lab work not covered. DOCTOR visit, Other PREVENTIVE, LAB WORK-REGULAR, HOSPITAL, OUTPATIENT EMERGENCY ROOM: are all subject to $2500 calendar year deductible, then: no charge. MATERNITY-additional $1250 inpatient deductible. ANNUAL PLAN MAX YOU COULD PAY: $2,500 + MATERNITY deductible--if applicable (Family max is x 2) |
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Use "Get Application" button to print an application OR to request one be mailed! |
| Accident Medical Coverage Only $25 monthly, Family or Single--Separate Company's Accident Plan--Pays up to $2,000 per ocurrence, plus if hospitalized, extra $150 per day--Fills in your deductible, and or helps pay your copercentage if care is due to an accident! |
Nationwide PPO Choice Classic
DOCTOR: $40 copay.PRESCRIPTIONS: $10 generic/$30 brand name "on-the-list"/50% brand name "not-on-the-list" (but not less than $45). PREVENTIVE: deductible waived--$300 max benefit--Dr. visit, you pay $40. PSA, mammogram, pap smear, you pay 10%. Well child Dr. visits, you pay 10%. Immunizations you pay $15. Preventive lab work you pay 10%. CHIROPRACTIC & ACUPUNCTURE: combined maximum of 12 visits per year are covered--once $2500 calendar year deductible is met, you pay all charges over $40 benefit per visit. LAB WORK-REGULAR: once $2500 calendar year deductible is met, you pay 10%. HOSPITAL: once $2500 calendar year deductible is met, you pay 10%. OUTPATIENT EMERGENCY ROOM: once $2500 calendar year deductible is met, you pay $75 + 10%. MATERNITY-additional $1000 inpatient deductible ANNUAL PLAN MAX YOU COULD PAY: $2,500 + deductibles (Family is x 2) |
Use "Get Application" button to print an application OR to request one be mailed! |
Blue Cross PPO PPO Share 2,500
DOCTOR: 25% copay, well child 50% Dr. copay. PRESCRIPTIONS: $10 generic; brand name $25 after $500 special calendar year deductible. PREVENTIVE: deductible waived--At your Dr.: PSA, mammogram, pap smear, you pay 25%; well child, you pay 50%. At the Healthly Check Center: you pay $25 or $75 (expanded) for Dr. exam & preventive lab. CHIROPRACTIC: maximum of 12 visits per year are covered--once $2500 calendar year deductible is met, you pay 25% per visit. ACUPUNCTURE: maximum of 12 visits per year are covered--you pay all charges over $25 per visit. LAB WORK-REGULAR: once $2,500 calendar year deductible is met, you pay 25%. HOSPITAL: once $2,500 calendar year deductible is met, you pay 25%.
OUTPATIENT EMERGENCY ROOM: once $2500 calendar year deductible is met, you pay $30 + 25%. MATERNITY-additional $1000 deductible ANNUAL PLAN MAX YOU COULD PAY: $5000 (Family is x 2) BUT Brand Name RX and MATERNITY deductbles do not count towards the maximum |
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Use "Get Application" button to print an application OR to request one be mailed! |
| Accident Medical Coverage Only $25 monthly, Family or Single--Separate Company's Accident Plan--Pays up to $2,000 per ocurrence, plus if hospitalized, extra $150 per day--Fills in your deductible, and or helps pay your copercentage if care is due to an accident! |
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Disclaimer and Explanation:
** The information on this page and in this web site is not a contract. It is provided as a summary and is meant only to give you an idea of what might be covered. Only the actual contract/policy provided (to you, if approved for coverage) by the health plan carrier would control what is a covered benefit or not.
Do not cancel any current coverage until you have received notice--in writing from the health plan carrier--that you have been accepted. Also do not cancel your current coverage until you have received and read the new contract/policy and agree with the terms, benefits, and exclusions etc. it describes.
Please understand that if you do not fully disclose all pertinent information on the application, it may give the health carrier cause to deny future claims and retroactively nullify your contract/policy so that it would be as if you never had the coverage. |
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Important! For Individual, family, and self employed plans, we only work with
California Headquartered Health Plans! Because out-of-state based health plans sometimes
pull out of California, leaving YOU scrambling for coverage (and if you have an existing
condition you are being treated for at the time, you may not be able to get other coverage)
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