For Kids Plans
| Balance Plan 1000 | Shield Spectrum PPO Plan 2000 | Active Start Plan 35 |
Access+ HMO® | |
| Starting Monthly Rate | $99* | $108* | $126** | $200** |
| Annual Deductible | $1,000 | $2,000 | no deductible | $2,000 |
| Out-of-Pocket Maximum | $5,500 | $7,000 | $7,500 | $3,000 |
| Preventive Care Exams | $30 | $45 | $35 | $20 |
| Office Visits | $30 | $45 | $35 | $20 |
| Hospitalization | $30 after annual deductible is met | $250 + 30% after annual deductible is met | $500 + 40% | $250 after annual deductible is met |
| Maternity? | No | Yes | No | No |
| ER Visit | $100 + 30% | $100 + 30% after annual deductible is met | $100 + 40% | $75 |
| Prescription Drugs | $10 for generic; $35 for brand name drugs after $500 Brand Rx deductible is met1 - Blue Shield pays up to $2,500 per year | $10 for generic; $35 for brand name drugs after $500 Brand Rx deductible is met 1 | $10 for generic; $35 for brand name drugs after a $750 Brand Rx deductible is met1 - Blue Shield pays up to $2,000 per year | $10 for generic; $35 for brand name drugs after $200 Brand Rx deductible is met1 |
| Download Plan Details | Balance Plan 1000 Details | Shield Spectrum PPO Plan 2000 Details | Active Start Plan 35 Details | Access+ HMO Plan Details |
If you have kids under the age of 19, these plans are a great choice. Costs for many services that kids often need are covered right away. And you can cover each child separately, so if you have more than one child you can place them on different plans.
Active Start Plan 35 is available for individuals only.
* Monthly rates are for children age 1-18 in good health, for the following counties: Alpine, Butte, Colusa, Del Norte, Humboldt, Imperial, Inyo, Kern, Kings, Madera, Mendocino, Plumas, San Benito, San Joaquin, Santa Barbara, San Luis Obispo, Siskiyou, Sonoma, Stanislaus, and Trinity counties. Rates may vary by age and region.
** Monthly rates are for children age 1-18 in good health, for the following counties: San Bernardino; Riverside zip codes 91752, 92248 and zip codes beginning with 923-28 except 92860, 92880, 92883; Orange except zip codes beginning with 926; Los Angeles zip codes 90247-51, 90260-61, 90274-75, 90500-10 and zip codes beginning with 906-912, 915, 917-18, 935; Ventura except zip codes beginning with 913. Rates may vary by age and region.
1Brand name benefit shown applies to formulary drugs. Member’s costs may increase for non-formulary brand name drugs if covered by the benefit plan.
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