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Basic Plans
Individual and Family Plans

Metal Level: Bronze

With some of our lowest premiums, a higher deductible, and more out-of-pocket costs for members, our Basic* plans are designed for those who want affordable coverage and protection in the event of a serious medical emergency. Your clients will enjoy three doctor visits before meeting the deductible. After the deductible is met, all covered benefits are paid in full.

Blue Shield pays approximately 60% of covered medical expenses.

Take a look at our plan benefits:

Platinum |  Gold |  SilverBronzeCatastrophicHSA-CompatiblePediatric Dental
Benefit After deductible, member pays
(with participating providers)1
Office visit – primary care doctor
(visit limit is a combination of any physician office visits, urgent care, outpatient mental health, outpatient substance abuse, and postnatal visits)
$60 for first 3 visits per calendar year prior to deductible2, then $60 after deductible
Office visit – specialist $70
Urgent care visit 
(visit limit is a combination of any physician office visits, urgent care, outpatient mental health, outpatient substance abuse, and postnatal visits)
$120 for first 3 visits per calendar year prior to deductible2, then $120 after deductible
Preventive health benefits $02
Inpatient hospitalization 30%
Outpatient surgery 30%
Lab 30%
X-ray  30%
Emergency room services not resulting in admission $300
Maternity 30%
Generic drugs $19
Preferred brand drugs $50
Non-preferred brand drugs $75
Chiropractic Not covered
Acupuncture
(from a licensed acupuncturist)
$60
Pediatric eye exam $02
Pediatric eyeglasses: lenses $02
Pediatric eyeglasses: frames 50%2
Pediatric contact lenses 25% if medically necessary/50% if elective2
Calendar year medical deductible $5,000 per individual/$10,000 per family
Calendar year out-of-pocket maximum
(includes deductible)
$6,350 per individual/$12,700 per family
Calendar year brand drug deductible
(brand drugs are subject to the calendar year medical deductible)
$0
This is an overview only. More detailed benefit information, including benefit information for non-participating providers, will be available in Septemer, 2013.
We also offer a Native American version of this plan for eligible Native Americans. The Native American plan provides the same benefits when accessing covered services from network and non-network providers, but allows Native American members to access covered services from Native American providers for $0 out of pocket. We also offer Native Americans the Native American 300 Subsidy plan. This plan allows Native American members to access covered services from Native American providers, Blue Shield network providers – and in some locations, even non-network providers – for $0 out of pocket.
*Pending regulatory approval.
1. The amounts indicated are a percentage of the allowable amounts. Participating providers accept Blue Shield's allowable amounts as payment-in-full for covered services.
2. Benefit is available prior to meeting any deductible.
Health Reform Resources
Learn more about these plans' metal levels (PDF, 198KB)
ACA Educational Series
Additional ACA information and resources
Covered California