While Covered California standard benefit design health plans have very specific limitations on member responsibility for in-network health care services, the coverage for out-of-network services can vary greatly between PPO health plans. The insurance carriers that offer PPO health plans through Covered California (Anthem Blue Cross, Blue Shield of California, and UnitedHealthcare) with out-of-network coverage seem to have made up their own rules for this PPO benefit. Because the Covered California individual and family health plans have such narrow networks, many families are finding that they must go out-of-network to receive certain health care services.
Blue Shield of California
Posts related to Blue Shield of California, primarily individual and family plans, billing issues, enrollment, health plans, small groups, Medicare.
$7 office visit, lab copay California family health plan
New for 2016 is a Blue Shield individual and family health plan that offers $7 primary care office visits. The new Blue Shield of California Silver Seven 3750 PPO also has $7 lab tests as well. The trade-off for the low $7 office visits and other health care services is $3,750 deductible and 30% coinsurance for services subject to the deductible.
Blue Shield denies seniors online enrollment
Blue Shield has redesigned their online enrollment website to exclude seniors turning 65 in 2016 from purchasing a health plan directly through their website. If an individual will be turning 65 years old within six months of the effective date of the plan they must apply with a paper application. The only online enrollment option is to use the Covered California enrollment website even if the individual doesn’t qualify for the ACA tax credits.
Blue Shield adds UC providers to networks, sort of
Blue Shield of California announced that they were adding University of California Medical Centers and Physician Groups as preferred providers for their individual and family, small group, and large employer health plan networks. Shortly after the initial announcement the UC hospitals and doctors were in-network; Blue Shield released another announcement to clarify that not all […]
How much do health insurance agents earn?
2020 was the year I was hoping to replace my 2002 CRV with 285,000 miles on it for new hybrid car. I don’t feel particularly optimistic about any significant revenue gains in 2020. While I picked up some new clients for 2020, I also lost just as many who have decided that health insurance is just too expensive.
Blue Shield estimates costs for health care services
One of the big complaints about health care services is not knowing or being surprised by the cost of medical treatment. Blue Shield of California has taken a modest step toward helping plan members determine the cost of health care services with their new treatment cost estimator tool. Initial reports from clients suggest the […]
Blue Shield and Sutter give the finger to members and patients
After an acrimonious contract fight where Blue Shield and Sutter Health where each accused the other of anti-consumer business practices, they have officially given the middle finger to their members and patients by signing a contract where the terms of the agreement are confidential. Regardless of how often Blue Shield and Sutter Health say the […]
Blue Shield and Sutter sign new contract for 2015
Blue Shield apology Sutter Health Information Blue Shield and Sutter sign a new two-year contract We are pleased to announce that Blue Shield and Sutter Health have signed a new two-year agreement effective February 1, 2015. This means that Sutter hospitals and doctors will continue to be participating providers in the Blue Shield network. We apologize […]
Blue Shield’s bumbling billing system bounces into 2015
In 2014 the combination of Covered California’s enrollment issues and Blue Shield’s bumbling billing system created massive headaches for Blue Shield’s members and their staff. With the dawn of 2015 we have witnessed that Blue Shield of California still hasn’t resolved many billing issues for individuals and families attempting to enroll in their health and […]
Blue Shield accuses Sutter Health of price gouging
Sutter Health patients love their doctors. Blue Shield of California has created a small public relations nightmare with their members when they announced that they would be dropping Sutter Health from their network of providers in 2015. To combat the image that Blue Shield is the bad guy in this battle of corporate health care titans, […]