BC Life & Health RightPlan PPO 40 (with Generic Prescription Drug Coverage)
Lifetime Maximum
In-Network
$5,000,000.00
Out-of-Network
$5,000,000.00
Out of Pocket Maximum
In-Network
$7,500.00 In and Out of Network Combined
Out-of-Network
$7,500.00 In and Out of Network Combined
Annual Deductible
In-Network
$0
Out-of-Network
$0
Office Visits
In-Network
$40 CoPay
Out-of-Network
50% of negotiated fee plus 100% of charges in excess of negotiated fee 1
Professional Services
In-Network
40% of negotiated fee
Out-of-Network
50% of negotiated fee plus 100% of charges in excess of of negotiated fee
Inpatient Hospital Services (Includes organ and tissue transplants)
In-Network
40% of negotiated fee plus $400 copay per day/4 day max per admission 2,4,5
Out-of-Network
All charges except $650 per day
Outpatient Hospital Services/Ambulatory Surgical Center
In-Network
40% of negotiated fee plus $400 copay per outpatient surgery admit 2,4,5
Out-of-Network
All charges except $380 per day
Emergency Care
In-Network
40% of negotiated fee 3
Out-of-Network
40% of C&R for first 48 hours plus 100% of charges in excess of C&R. After 48 hours all charges in excess of $650 per day 3,7
Maternity
In-Network
Not Covered
Out-of-Network
Not Covered
Preventive Care/HealthyCheck Center
In-Network
$25 or $75 option
Out-of-Network
Not covered
Preventive Care
In-Network
$40 office visit plus 40% of negotiated fee for well-baby and well-child thru age 6
$40 office visit plus 40% of negotiated fee for Covered Services other than the Office Visit for Annual Pap exam Breast exams Mammogram testing and appropriate screeni
Out-of-Network
All charges in excess of 50% of negotiated fee for well-baby and well-child thru age 6
All Charges in excess of 50% of negotiated fee
Ambulance Service
In-Network
40% of negotiated fee
Out-of-Network
All charges in excess of 50% of negotiated fee
Physical Therapy, Occupational Therapy/Chiro
In-Network
40% of negotiated fee; limited to 12 visits/year, participating and non-participating combined
Out-of-Network
All charges except $25 per visit
Acupuncture/Acupressure
In-Network
All charges except $25 per visit; limited to 24 visits/year, participating and non-participating combined
Out-of-Network
All charges except $25 per visit; limited to 24 visits/year, participating and non-participating combined
50% of Drug Limited Fee schedule less the copay as stated for participation pharmacies
Here at Santa Barbara Health Insurance Services we know that no web site
can substitute for courteous service from an experienced professional. Our staff
is always happy to help with your California health insurance, California dental
insurance, or term life insurance needs. Feel free to call us any time at (800)
765-1540.
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Testimonials...
"Santa Barbara Health Insurance helped us improve our health benefits and has saved us a significant amount of money. We highly recommend them."
- Renee Grubb, Co-Owner of Village Properties Realtors
"Rob and Steve at Santa Barbara Health Insurance have been thorough, professional, and very easy to work with. They helped us transition to
a Health Savings Account strategy which benefits our employees and our company."
- Dave Larson, Managing Partner at McGowan Gunterman CPA's
“The guys at Santa Barbara Health Insurance are always available to answer our questions and have given us great service. It is almost like
they are right next door.” - Scott Branch, Partner, Burnell, Branch, and Pester Architects.
“When I broke my wrist skateboarding, the Blue Cross Tonik plan that Rob set me up with really came through big and saved me from racking
up huge debts.”
- Peter Schick, Individual.
Santa Barbara Health Insurance Services