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Starting July 1, Covered California for Small Business (CCSB) is offering new Blue Shield plans, providing more options for enrollees. These plans include the Access+ HMO Network with Platinum, Gold, and Silver metal tier options, as well as the Bronze Trio HMO 7000/70. The two most popular Blue Shield High Deductible Health Plans (HDHP), Silver Full PPO Savings 2300/25% and Bronze Full PPO Savings 7000 plans, are also now available.
All of these plans offer benefits such as Wellvolution, Teladoc Mental Health, Nurse Help 24/7, LifeReferrals 24/7, and the Blue Card program for when members are outside of California.Login To Prism
Explain out-of-pocket costs. Do clients have to pay for medical services first to the out-of-pocket maximum of $6,350 for individuals before insurance kicks in?
Out-of-pocket costs are the consumers’ expenses for medical care that aren’t reimbursed by insurance. Out-of-pocket costs include deductibles, co-insurance and co-payments for covered services plus all costs for services that aren’t covered.
The out-of-pocket maximum is the most consumers pay during a policy period (usually one year) before their health insurance or plan starts to pay 100% for covered essential health benefits. This limit must include deductibles, coinsurance, copayments, or similar charges and any other expenditure required of an individual which is a qualified medical expense for the essential health benefits. This limit does not have to count premiums, balance billing amounts for non-network providers and other out-of-network cost-sharing, or spending for non-essential health benefits.
There may be a more recent answer to this question. Contact Claremont for an update.