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Bronze 60 Plans
Individual and Family Plans

Blue Shield pays, on average, 60% of covered medical expenses


Effective January 1, 2015

With some of our lowest premiums, a higher deductible, and more out-of-pocket costs for members, our Bronze 60 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, which means Blue Shield pays approximately 60% of the overall costs for covered medical services.
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 $15
Preferred brand drugs $50
Non-preferred brand drugs $75
Chiropractic Not covered
Acupuncture
(from a licensed acupuncturist)
$60
Pediatric dental cleaning and X-rays $0
Pediatric dental filling – 1 surface (amalgam) 20%
Pediatric dental root canal – molar 50%
Pediatric eye exam $02
Pediatric eyeglasses $02
Calendar year medical deductible $5,000 per individual/$10,000 per family
Calendar year out-of-pocket maximum
(includes deductible)
$6,250 per individual/$12,500 per family
Calendar year brand drug deductible
(brand drugs are subject to the calendar year medical deductible)
$0
For complete medical plan details, see the Benefit Summaries and Legal Disclosures.

Rates for our medical plans can be obtained immediately from our IFP rate books or through our online Quote & Apply tool beginning November 15, 2014.
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.
3. Rates and benefits are pending regulatory approval.
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