California Health Insurance Quotes
Find the Best Health Insurance Plans and the Cheapest Rates
California Health Insurance Agent Matt Lockard
Hi, I'm Matt Lockard, and I enjoy helping California residents find the best health plan for their needs at the cheapest rates available. I am an Independent California Health Insurance Agent and an authorized agent for the following companies:
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No CommentsIntroducing SmartSense.
Smart health coverage with sensible savings.
If you want reliable, essential protection at some of most affordable monthly rates, SmartSense could be the health plan you’re looking for.
What makes SmartSense so smart is how it balances solid health coverage with opportunities to save money, including:-
A wide range of annual deductible/monthly rate combinations. Just choose the one that fits your budget.
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Lower rates on services when you use our network of more than 50,000 doctors and 400 hospitals. This means your share of medical costs will be lower, too.
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Immediate benefits for your first three in-network doctor visits. You’ll just have copays with no deductible to meet.
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A choice of prescription drug benefits (brand-name and generic drugs, or (generics only). This helps keep your out-of-pocket prescription costs to a minimum.
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Health and wellness programs. The healthier you are, the more you’ll save on health care.
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Out-of-state coverage. This protects you from the high cost of unexpected emergencies when you travel.
For a total benefit solution, we also offer a wide range of dental and term life coverage options.
SmartSense benefits at-a-glance
These amounts show your share of costs after deductibles, if any.
Plan BenefitIn-NetworkReceive negotiated savings
Out-of-networkPay higher costs
Lifetime Maximum(combined for in and out-of-network)
Health plan pays up to$7,000,000 per member
Health plan pays up to$7,000,000 per member
Annual Deductible Choices(not combined for in and out-of-network)
Single member: $500/$1,500/$2,500/$5,000Family maximum1: $1,000/$3,000/$5,000/$10,000
Single member: $5,000Family maximum: $10,000
Annual Out-of-Pocket Maximum2(in addition to deductible; not combined for
in- and out-of-network)
Single member: $2,500Family maximum: $5,000
Single member: $10,000Family maximum: $20,000
Doctors’ Office Visits$30 copay for first three visits3 per member per year (deductible waived); after three visits and once deductible is met, then 30% of negotiated fee50% of negotiated fee plus all excess charges
Professional Services(x-ray, lab, anesthesia, surgeon, etc.)
30% of negotiated fee50% of negotiated fee plus all excess charges
Hospital Inpatient(overnight hospital stays)
30% of negotiated feeAll charges except $650 per day
Hospital Outpatient(if you don’t stay overnight)
30% of negotiated feeAll charges except $380 per day
Emergency Room Services430% of negotiated fee50% of customary and reasonable fees plus all excess charges
MaternityNot coveredNot coveredPreventive CareAnnual physical exam(s): 30% of negotiated fee
Routine mammogram, Pap and PSA tests5: 30% of negotiated fee
Well Baby and Well Child (through age 6): 30% of negotiated fee
Annual physical exam(s): 50% of negotiated fee plus all excess charges
Routine mammogram, Pap and PSA tests5: 50% of negotiated fee plus all excess charges
Well Baby and Well Child (through age 6): 50% of negotiated fee plus all excess charges
Ambulance30% of negotiated fee50% of negotiated fee plus all excess charges
Physical/Occupational/Speech Therapy; Chiropractic Services30% of negotiated fee Plan pays up to $2,500 per year for therapy and up to $500 per year for chiropractic services50% of negotiated fee plus all excess charges Plan pays up to $2,500 per year for therapy and up to $500 per year for chiropractic services
Prescription Drug Coverage OptionsIn-Network
Receive negotiated savings
Out-of-network
Pay higher costs
SmartSense with Generic Prescription Drug CoverageGeneric(drugs on Generic Rx formulary only)
Generic: $15 copay (or 40%, whichever is greater)
Generic: $15 copay (or 40%, whichever is greater)
SmartSense with Comprehensive Prescription Drug Coverage
(Anthem Blue Cross Formulary Drugs)
Generic: $15 copay (or 40%, whichever is greater)
$500 annual brand-name/specialty drugBrand-name6: $15 copay (or 40%, whichever is greater7); 40% of negotiated fee for self-administered injectables, except insulinSpecialty8: 40%$4,500 annual out-of-pocket maximum (the most you will have to pay) (In-network only and in addition to brand-name/specialty drug deductible)9
deductible (2-member maximum) applies before the following:
Generic: $15 copay (or 40%, whichever is greater)$500 annual brand-name/specialty drugBrand-name6: $15 copay (or 40%, whichever is greater7); 40% of negotiated fee for self-administered injectables, except insulinSpecialty: Not covered
deductible applies before the following:
1 Once a member meets their single deductible, their deductible is satisfied. After one family member’s single deductible is satisfied, the family maximum can be met by two or more family members.
2 Excludes non-participating charges in excess of the Anthem Blue Cross negotiated fee and non-participating charges in excess of customary and reasonable fees for emergency care. Copays/coinsurance to participating and non-participating providers apply to out-of-pocket maximum except where specifically noted in the policy.
3 Applies to first three preventive care visits and/or doctors’ office visits.
4 Additional $100 copay applies for each emergency room visit. Waived if admitted as inpatient.
5 Tests ordered by a physician are covered, including appropriate screening for breast, cervical and ovarian cancer.
6 If a member selects a brand-name drug when a generic equivalent drug is available, even if the physician writes a “dispense as written” or “do not substitute” prescription, the member will be responsible for the generic copay plus the difference in cost between the brand-name drug and the generic equivalent drug. The amount paid does not apply to the member’s brand-name deductible.
7 Not to exceed $500 maximum (the most you would need to pay) per brand-name prescription.
8 Specialty drugs include injected, infused, oral and inhaled medications that generally need to be closely monitored by your doctor. These drugs tend to be higher in cost and often require special handling and ordering.
9 The annual brand-name/specialty drug deductible and annual brand-name/specialty drug out of-pocket maximum are separate from the annual medical deductible and annual medical out of maximum. They are not combined for in-network and out-of-network.
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