Blue Cross of California Lumenos HSA 3000 California Health Insurance Plan Details

Insurance Plan Summary
Company
Blue Cross of California
Plan Name
Lumenos HSA 3000
Plan Type
PPO
Primary Care Physician Required
No 
Specialist Referrals Required
No 
HSA Eligible
Yes 
Out-of-Network Coverage
Yes
In-Network Coverage
Coinsurance
30% after deductible 
Office Visit
 
Primary Doctor
30% Coinsurance after deductible 
Specialist
30% Coinsurance after deductible 
Periodic Health Exam
No charge (deductive waived) 
Periodic OB-GYN Exam
No charge (deductive waived) 
Well Baby Care
No charge (deductive waived) 
Chiropractic
30% after deductible, limited to 12 visits Max. per year 
Mental Health
Plan pays $25 per visit after deductible, up to 20 visits per calendar year 
Prescription Drugs
 
Generic
30% Coinsurance after deductible 
Brand
30% Coinsurance after deductible 
Non-Formulary
N/A 
Separate Rx Deductible
Medical Plan Deductible Applies 
Mail Order
Available
Outpatient Lab/X-Ray
30% Coinsurance after deductible 
Emergency Room
30% Coinsurance after deductible 
Outpatient Surgery
30% Coinsurance after deductible 
Hospitalization
30% Coinsurance after deductible 
Maternity
 
Pre & Postnatal Office Visit
Not Covered 
Labor & Delivery Hospital Stay
Not Covered 
Additional Information
Will insurance company obtain and pay for medical records?
Yes
eSign
(electronic signature)
Yes
A.M. Best Rating
A
as of 11/06/2006
More Insurance Plan Details
More Details
Exclusions and Limitations
Exclusions and Limitations
Actions
Company
Blue Cross of California
Plan Name
Lumenos HSA 3000
Get live professional advice about this insurance plan
Get Live Advice
categories [ ]



Tonik Have you seen Tonik? Three simple, affordable health insurance plans to cover your A-Z. Body, eyes, teeth. You know, the important stuff. Click the Tonik link for details.
BeneFits

Are you a business owner wanting to offer health coverage for the first time?  Want the solution?  BeneFits with its lower participation requirements, lower contribution levels and lower price point is the answer.  For the most simple and affordable health care portfolio, click the BeneFits link for details.