BAY AREA HEALTH INSURANCE

*Call Us Today!* *(650) 580-6337*
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BAY AREA HEALTH INSURANCE

Call Us Today!

(650) 580-6337

Bay Area Insurance

agent Dolly Hebert

CA License # 0F60912

Authorized Bay Area

insurance agent for

Blue Shield of California.

health insurance in bay area ca

BAY AREA HEALTH INSURANCE

COMPARE ALL PLANS & RATES HERE

Vital Shield Plus Our newest and most popular plan, has 5 preventive care office

visits per calendar year, generic drug coverage and a carry over deductible

feature. Available to individuals and families.

If you don't see what you're looking for, please contact us or call (650) 580-6337

CHOOSE A PLAN HERE

Vital Shield Plan *Popular Insurance Program
Balance Plan *Popular Insurance Program
Shield Savings Plan *Popular HSA Compatible Plan
Vital Shield Plus Plan *Newest & Most Popular Plan
Essential Plan
Active Start Plan
Shield Spectrum PPO *Maternity Benefit Included
HMO Plan
Blue Shield Dental Plans *Popular PPO Program

The Blue Shield Advantage

Low copay for office visits & preventative care

Low medical deductibles

$10 generic prescription copay

Special rates for children under age 19

Well baby care

Acupuncture and Chiropractic coverage

Optional dental and vision coverage

Plans with maternity coverage

Is a Vital Shield plan right for you? *Popular Insurance Program

Vital Shield^SM plans* cover you with basic benefits and a low or moderate deductible in case of hospitalization, surgery or other major medical events. The lower-priced PPO options cover two office visits and generic drugs, before you have to meet a deductible. They are available for individuals only and offer many popular benefits, so you don't pay for services you don't expect to use, such as maternity care or brand-name drug benefits.

Plan Features

		Monthly rates starting at $52**
		Affordable annual deductible options ($900 or $2,900)
		You're covered at 100 percent after you meet the copayment maximum ($4,900 or $5,900)
		$10 copayments for generic prescription drugs at network pharmacies
		Two $40 copayment annual office visits, which can be used for preventive care or medical treatment prior to meeting the deductible
		One of California's largest PPO provider networks, so it's easy to find a doctor you want
		Knowledgeable customer service representatives ready to help you and answer your questions

^{*Underwritten
by Blue Shield of
California Life &
Health Insurance
Company. Pending
regulatory approval.}

^{**Monthly rate
for individual male
aged 19-29 for
Colusa, California.
The rate shown is
for people in good
health. Other rates
may apply.}

Is a Vital Shield Plus plan right for you? *Newest & Most Popular Plan

Vital Shield^SM Plus plans* provide the vital health coverage you need with a range of deductible options and $30 office visit copayments. And this PPO plan family offers you affordable and simplified coverage and protects you in case of major medical events, such as hospitalization. These plans are available for change to individual and family and are limited to basic benefits, like no maternity, so that you don't pay for services you don't expect to use.

Plan Features

		Annual deductible options of $400, $900 or $2,900
		5 calendar-year office visits for preventive care, before you have to meet the deductible, so you will get the care you need in case of injury
		Generic prescription drug coverage right away, before you have to meet a deductible, for only $10 at network pharmacies
		100% coverage after you meet the coinsurance maximum
		Carry-over deductible feature

^{*Underwritten by
Blue Shield of
California Life &
Health Insurance
Company. Pending
regulatory approval.}

Is an Essential plan right for you?

Essential plans simplify getting the coverage you need by combining medical, dental, and vision benefits
all in one plan. These individual-only plans 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
		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)**

- 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

^{*Underwritten
by Blue Shield of
California Life &
Health Insurance
Company. Essential
plan 1750 is subject
to regulatory
approval.}

^{**For the first
three visits per
calendar year only.
Subsequent visits
are subject to the
deductible. No
charge after
deductible is met.}

Is an Active Start plan right for you?

Whether you’re an adult or child, you can appreciate our Active Start^SM plans’ low generic drug and preventive care office visit copayments with no annual deductible. Plans offer a blend of lower costs and comprehensive benefits for active individuals who want coverage in case of a serious medical event, but also want to take care of more routine day-to-day healthcare needs. The economical Active Start plans* offer individual coverage only and do not provide maternity benefits.

Plan Features

		Two plans with generic-only prescription drug coverage options to help save costs
		$10 copayments for generic prescription drugs at participating pharmacies
		Healthcare coverage for individuals**
		No medical deductible, so your coverage starts immediately
		$25 or $35 copayments for preventive care and office visits
		Alternative care benefits for acupuncture and chiropractic services
		Access to one of California's largest PPO preferred provider networks

^{*Underwritten
by Blue Shield of
California Life &
Health Insurance
Company. Active
Start Generic Rx
plans are pending
regulatory approval.}

^{**Active Start
Plans are for
individuals only and
do not provide
maternity coverage.}

Is a Balance plan right for you? *Popular Insurance Program

You have a family and want the balance of solid coverage with a relatively low deductible and rates.
Balance^SM plans* provide coverage for preventive care, doctor’s office visits, generic prescription
coverage, and emergency room care right away, before you meet your deductible. Additionally,
they offer easy access to chiropractic care and acupuncture, and a wide range of other quality
benefits. All Balance plans feature the same copayments, so you can choose which deductible
amount best suits your needs.

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

^{*Underwritten by
Blue Shield of
California Life
& Health
Insurance
Company. Plans
are subject to
regulatory
approval.}

Is a Shield Spectrum PPO right for you? *Maternity Benefit Included

You may have a family and want thorough coverage for doctor visits, prescription drugs and hospital
care. With a wide range of deductible options to meet your needs, Shield Spectrum PPO^SM plans make
it easy to visit the doctors and specialists you want and let you choose your deductible coverage.
Keep in mind, when you receive care from Blue Shield PPO network providers your out-of-pocket
costs are always lower.

Plan Features

Coverage for preventive care, prescription drugs, hospitalization and more

A range of deductible options

Preventive care benefits for a fixed copayment before you meet your health plan deductible

Prescription generic drug benefits at participating pharmacies before you meet your brand-name drug deductible

Pay 25% or 30% for many covered services (depending on deductible level) after meeting the deductible for preferred providers

Choice of providers every time you seek covered services. There are lower out-of-pocket costs when you choose from over 45,000 preferred providers.

Chiropractic care benefits¹ before you meet your deductible

^{1
Shield
Spectrum PPO
Plan 5000
does not
offer
coverage for
chiropractic
care
benefits.}

^{2
Underwritten
by Blue
Shield of
California
Life &
Health
Insurance
Company.}

Is a Shield Savings plan right for you? *Popular HSA Compatible Plan

These high-deductible health plans offer preventive care before having to meet the deductible,
are compatible with a Health Savings Account (HSA), and offer you protection against major
healthcare expenses.

Plan Features

		To help you stay healthy, preventive care benefits are provided right away for a fixed copayment, before meeting any deductible
		Your out-of-pocket maximum includes your plan deductible, so you’ll pay only up to your plan’s out-of-pocket maximum in a calendar year.
		No copayment for covered prescription drugs once you meet the out-of-pocket maximum and convenient access to a mail service pharmacy benefit.
		For Shield Savings plans 1800/3600² and 4000/8000²: • Once the family deductible is met, all remaining covered family members will have met their deductible. The family deductible can be met by any family member or combination of family members.
		For Shield Savings plans 3500² and 5200²: • When two or more family members are on one plan, each covered individual has his or her own individual deductible, in case only one person needs expensive medical care.
		Compatible with Health Savings Accounts.

Maternity benefits and well-baby care with no waiting period¹.

Bridge Plan (hospital insurance indemnity rider)

Offered exclusively with Shield Savings Plans 3500, 4000/8000 and 5200

If you’re excited about the cost savings that an HSA-compatible high-deductible health plan offers, but concerned about saving up enough money to pay for your medical deductible should you be hospitalized in the first year, no need to worry. With the Bridge Plan you get the security and peace of mind of helping to supplement your health coverage, during your first year as a member. Bridge Plan gives you the security of knowing that if something happens before you’ve built up funds in an HSA, you have a backup. The affordable annual premium for the 12-month term of coverage is $60 for an individual and $120 for a family, and will be billed on a monthly basis.

^{1
Maternity
coverage not
provided
with Shield
Savings
Plans
1800/3600, 3500/5200 and 4000/8000.}

^{2
Underwritten
by Blue
Shield of
California
Life &
Health
Insurance
Company.
Plans may be
pending
regulatory
approval.}

Is an HMO right for you?

Blue Shield's affordable HMO plans offer a predictable, cost-efficient way to manage your health care, especially if you or your dependents visit the doctor often.

Plan Features

Preventive, routine and catastrophic care

Access + Specialist allows you to visit a participating specialist within your Personal Physician's medical group without a referral for just a $50/$35 copayment

Preventive care services for a small copayment

Prescription generic drugs are only $10 per prescription at participating pharmacies

Choose a Personal Physician from an extensive network. Office visits with your Personal Physician are covered with a $35/$20 copayment

Built-in dental services for no extra monthly dues through Access + Dentist with Access+ HMO^®

Practically no claim forms

No lifetime maximum on plan benefits

Blue Shield Dental Plans

Dental HMO

With our dental HMO plan, you'll choose a dentist from more than 8,600 dental providers in our directory. The dentist selected will provide and coordinate your family's dental care.

Plan Features

		No deductibles and no calendar year maximums
		A wide range of dental benefits, including most diagnostic and preventive services at no charge
		Specialty care available with a referral from your dental provider
		Virtually no claim forms
		No waiting period for most services (There is a 12-month waiting period for orthodontic services.)

Blue Shield now offers a range of affordable and comprehensive dental PPO plans available with or without Blue Shield medical plans. With our dental PPO plans, you have the freedom to choose any dentist you want. Your out-of-pocket costs are lower when you receive care from network dentists. With Blue Shield’s broad dental network including nearly 20,000 general and specialty care dentists in California, you’ll have access to one of the largest dental networks in California.²

Dental plan offered with Blue Shield medical plans³

Dental PPO *Popular Insurance Program

The Dental PPO plan is an ideal choice to complement your Blue Shield medical plans. This plan provides you and your dependents comprehensive dental benefits at an attractive rate. While strengthening your overall health coverage, you also enjoy the added convenience of a single point of contact for your customer support.

Dental PPO Plan features

		Two annual teeth cleanings including X-rays covered at 100% when using network providers.
		Low copayments for basic and major services.
		Fixed copayments when using network dentists.
		No waiting period for diagnostic or preventive services (there’s a 3-month waiting period for minor restorative services and 12-month waiting period for major restorative and orthodontic services).
		Orthodontic benefits for children and adults.⁴
		Coverage even when you use an out-of-network dentist.
		An individual annual deductible of $50 per member.
		A $1,000 per member, per calendar-year benefit maximum, of which $500 per member, per year can be used for non-network benefits.⁵
		Enhanced dental benefits for pregnant women.⁶

Introducing two new dental plans offered independent of Blue Shield medical plans³

You can now enjoy the great value and protection of Blue Shield dental coverage, even if you don’t enroll in a Blue Shield medical plan. Choose between a comprehensive Smile^SM PPO^†,1,3 and an affordable Value Smile^SM PPO^†,1,3 plan.

Smile PPO plan features

		Two annual teeth cleanings including X-rays covered at 100% when using network providers.
		Low copayments for basic and major services.
		Fixed copayments when using network dentists.
		No waiting period for diagnostic or preventive services (there’s a 6-month waiting period for minor restorative services and 12-month waiting period for major restorative and orthodontic services).
		Orthodontic benefits for children and adults.⁴
		Coverage even when you use an out-of-network dentist.
		An individual annual deductible of $50 per member.
		A $1,000 per member, per calendar-year benefit maximum, of which $500 per member, per year can be used for non-network benefits.⁵
		Enhanced dental benefits for pregnant women.⁶

Value Smile PPO plan features

		Two annual teeth cleanings including X-rays covered at 100% when using network providers.
		Low copayments for basic services.
		Fixed copayments when using network dentists.
		No waiting periods.
		Coverage even when you use an out-of-network dentist.
		An individual annual deductible of $25 per member.
		A $500 per member, per calendar-year benefit maximum.⁵
		Enhanced dental benefits for pregnant women.⁶

^† Pending regulatory approval.
¹ Value Smile PPO and Smile PPO plans are underwritten by Blue Shield of California Life & Health Insurance Company (Blue Shield Life).
² Dental providers in and out of California are contracted through a dental plan administrator.
³ To be eligible for enrollment, you must be a California resident and under age 65 at the time of enrollment. If you had a Blue Shield IFP dental plan cancelled, you must wait 12 months from the date of cancellation before you can reapply.
⁴ The Dental PPO and Smile PPO plans cover orthodontic services with a fixed copayment, which does not apply to your $1,000 calendar-year benefit maximum.
⁵ For each calendar year, you are responsible for all charges incurred after the benefit plan maximum has been reached.
⁶ The plan covers one additional routine adult prophylaxis for women during pregnancy. Dental PPO and Smile PPO additionally include one periodontal maintenance visit if warranted by a history of periodontal treatment and one course (up to four quadrants) of periodontal scaling and root planning for women during pregnancy with a documented existing periodontal condition.

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