Blue Cross Child plan

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Blue Cross offers Major Medical Coverage for Children ages 1-19 with a $250 deductible 80/20 with a maximum coinsurance, out of pocket of $1,000. If using a non-preferred Blue Cross provider, the coverage is reduced. The major medical plan offers comprehensive coverage with preventive care benefits for children under the age of 16. Outpatient emergency care is covered at 100% with no deductible.

Blue Cross offers two types of coverage for children, ages 1 to 19. Blue Cross offers a major medical plan that covers inpatient and outpatient charges as well as a children's "alternative" plan. The major medical plan is outlined here.

To see an an outline of the hospital/surgical plan for children, please view the "Alternative" page for an outline of the children’s alternative.

Monthly Rates for Year 2000
Ages 1-5 Years	$ 88.00
6-14 Years	$ 74.50
15-19 Years	$ 115.50

Plan Highlights
PPO Network	Blue Cross
Maternity	No
Well Care	Yes
Rx Card	No
Office Copay	No
App. Fee	No

Preexisting condition clause - Upon acceptance, there is no waiting period before benefits are paid for pre-existing conditions that are listed on the applicaiton. For pre-existing condtions not listed on the application, there is a 365-day waiting period.


	The following summary is NOT a solicitation to sell you insurance. Solicitations can only be made with state, and insurance company, approved brochures. Information contained in this web may contain generalities or inaccuracies. Please read the brochures and policies for specific limitations and exclusions.


	Blue Cross Child Only Plan

Benefit Description	In Network Benefits	Out of Network Benefits
Calendar Year Deductible (3x per family)	$250	$250
Coinsurance	80%	80% & 60%
Out of pocket limit (plus deductible 3x per family)	$1000	$5000
Primary care and specialist Office visits	Subject to deductible, then covered at 80%	Subject to deductible, then covered at 80%
Hospital Charges	Subject to deductible, then covered at 80%	Subject to deductible, then covered at 60%
Preventive care Services provided by a Dr. to age 16 for immuniztions and physical exams. up to $250 per year.	Deductible waived, then covered at 50%	Deductible waived, then covered at 50%
Other Physician Services Office visits Surgical procedures Assistant surgeons Anesthesia Outpatient X-ray, lab test, diagnostic imaging, radiation therapy.	Subject to deductible, then covered at 80%	Subject to deductible, then covered at 80%
Hospital Services Inpatient- semi private room Pre-admission testing Outpatient surgical facility Other Outpatient charges	Subject to deductible, then covered at 80%	Subject to deductible, then covered at 60% Additional $300 Deductible per inpatient admission.
Other Services Hospice Home Health Care Extended Care facility Medical Equipment and supplies	Subject to deductible, then covered at 80%	Subject to deductible, then covered at 80%
Mental Health Benefits Inpatient Benefits Outpatient Benefits Out of pocket max. does not apply with mental nervous claims. Lifetime max benefits $10,000.	Inpatient care limited to $1,000 per calendar year. covered at 50%. Outpatient- $500 calendar year, at 50%	Inpatient care limited to $1,000 per calendar year. covered at 50%. Outpatient- $500 calendar year, at 50%
Prescriptions Electronic filing at most major Rx.	Covered at 80% after deductible.	Covered at 80% after deductible.
-Outpatient Emergency	Deductible Waived, Covered at 100% for accident or Illness	Deductible Waived, Covered at 100% for accident or Illness
LIFETIME MAXIMUM	$1,000,000	$1,000,000

Blue Cross Members First Package of benefits included:

Vision Plan -Pay Just $25 for an eye exam for glasses. Discounts from 100 statewide centers. Not covered by plan.

Dental Program -Reduced pricing from member dentists save 25% or more. Not covered by plan.

Hearing Program - receive discounts on hearing aids and hearing aid evaluations. Pay as little as $49 for a basic hearing exam.

Pre-certification - Notification required prior to all elective hospital admissions. Emergency and Maternity notification required within 2 business days of admission.