Blue Shield of California Adds Plans With Maternity and Autism Coverage

With the impending California requirement to cover maternity and autism benefits in family and individual plans, Blue Shield of California has taken that opportunity to update their portfolio of health insurance plans.

Simpler Comparisons

Their new IFP portfolio, Shield Complete, features 11 new plans that are simpler to compare to one another. The new plans also reflect a migration to benefit summaries that are easier to understand as outlined by the Affordable Care Act, healthcare reform. It has always been one of my criticisms that the marketing of health insurance plans purposefully obfuscated certain limited benefits of the plans. With the introduction of the new Blue Shield plans, we are getting closer to consumers being able to compare apples with apples.

Aside from the essential hospital benefits that all health insurance plans must cover, the real monthly premium cost drivers are the deductible, number of office visits with a set copay, coinsurance and the pharmacy benefit. Blue Shield of California has done a nice job of creating a set of plans with a natural progression from benefit rich to simple and affordable.

Download new plan summaries, large file at 7mb [download id="25"]

Some of the plan highlights:

  • Brand-name drugs, acupuncture, chiropractic, and rehabilitation benefits are included
  • Available for both individuals and families – no more subscriber-only plans
  • A variety of medical and brand-name prescription drug deductibles for an assortment of plan options and price points.

Women’s Preventive Health Services

For all open and closed non-grandfathered plans, preventive health services will now include the following

benefits without a copayment:

•           Gestational diabetes screenings

•           Contraceptives

•           Tubal ligations

•           Breastfeeding supplies and counseling

•           Domestic violence screening and counseling

Behavioral Health Treatment

All plans – including closed and open, grandfathered and non-grandfathered plans – will include coverage for Behavioral Health Treatment, which is defined as professional services and treatment programs, including  applied behavior analysis and evidence-based intervention programs that develop or restore, to the maximum extent practicable, the functioning of an individual with autism, Asperger Syndrome, or Pervasive Developmental Disorder-Not Otherwise Specified (PDD-NOS).

Plan Closings

With the introduction of the new portfolio of plans Blue Shield of California will be closing their existing plans of Active Start, Essentials, Vital Shield, Balance, Shield Savings and Vital Shield Plus. Current members can remain in the plans.

Their new HSA eligible plan will be called Shield Saver 4000 and Shield Saver 6000.

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