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Active Start Plan 35 Frequently Asked Questions
How is Active StartSM Plan 35 different?
Active Start Plan 35* combines no medical deductible, low generic prescription drug copayments and $35 copayments for office visits and preventive care in one affordable PPO plan. If affordability has prevented your clients from having healthcare coverage, you may want to have them consider all the advantages provided by Active Start Plan 35. Also, Active Start Plan 35 coverage is available to individual subscribers only (no spouse, domestic partner or dependent coverage is available). The plan does not provide maternity coverage.
Can families receive coverage under this plan?
The Active Start Plan 35 was designed and priced for single subscriber coverage only.  Spouses and dependents must apply for their own individual coverage. Although each household may apply for his or her own Active Start Plan 35 using the same application, they will each receive separate contracts and separate billing. Since each subscriber applying for coverage is individually rated, Blue Shield is able to deliver more affordable premiums to your clients.
Is maternity care covered?
In order to keep the plan cost low, Active Start Plan 35 does not include maternity care.
Is alternative care such as chiropractic and acupuncture covered?
Yes, acupuncture and chiropractic are covered. However there are visit limits on both benefits. Acupuncture/acupressure has a 12-visit combined annual limit, and chiropractic is limited to 12 visits per year combined with speech therapy and rehabilitation services.
Is preventive care covered?
Yes, the Active Start Plan 35 includes coverage for preventive care such as physical examinations, immunizations and gynecological exams when a preferred provider is used. (For infant immunizations, the baby must be enrolled as an individual subscriber in his or her own plan.)
Can a client choose his or her own doctor?
Yes. Active Start Plan 35 uses the same Blue Shield Life network as our other Blue Shield Life PPO plans. (Please note that the Blue Shield Life network is not the same network as the Blue Shield of California network.)
This plan has low generic prescription drug copayments. But what if a client needs brand-name prescription drugs?
Formulary brand-name drugs are available for a $35 copayment, and non-formulary brand-name drugs are available for a $50 copayment or 50% of the cost, whichever is greater. Brand-name drugs are subject to an annual $750 brand-name drug deductible per person, and a calendar year benefit maximum of $2000.
Are my clients covered while traveling?
Yes. The Blue CardÒ program applies to Active Start Plan 35 just like it does to other Blue Shield IFP plans.
What is the lifetime benefit maximum?
The lifetime benefit maximum is $6,000,000.
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* Underwritten by Blue Shield of California Life & Health Insurance Company
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