What Is the Difference Between Blue Shield Silver 87 Ppo and 87 Trio Hmmo

July 16, 2022 Post a Comment

Serving ALL of California Since 1998
949-486-6018

Need Help Renewing with CoveredCA.com?

Open Enrollment 2022

Marc's analysis of BLUE SHIELD HMO!

020 Strategy: Although you will see some plan design changes and may see a smaller network of doctors and/or hospitals starting 1/1/20, Marc is recommending to stick with your current plan this year. Have faith, and play the odds, if you need a doctor out of network, just pay cash!

- Get the BEST VALUE

- Licensed CERTIFIED Agent

- 21 Years of Experience

Silver 94, 87 & 73 Enhanced CSR
Must have low-income to qualify:
Silver 94 - $75 Deductible
$5 Dr. Visit Copay / $8 Specialist

$5 Urgent Care $50 ER Visit

$8 Lab / $8 X-ray
Rx: $3 Generic / $10 Tier 2 / $15 Tier 3
10% Hospitalization
10% Outpatient Surgery

10% Inpatient Surgery ( After Deductible )

$1,000 Out of pocket maximum (2 max)

Silver 87 - $800 Deductible / $0 Rx
$15 Dr. Visit Copay / $25 Specialist
$15 Urgent Care $150 ER Visit
$20 Lab / $40 X-ray
Rx: $5 Generic / $ 25 T2 / $ 45 T3 ( After Ded .)
15% Hospitalization
15% Outpatient Surgery
15% Inpatient Surgery ( After Deductible )
$2,850 Out of pocket maximum (2 max)

Silver 73 - $3,700 Deductible / $10 Rx
$35 Dr. Visit Copay / $75 Specialist
$35 Urgent Care
$40 Lab / $85 X-ray
Rx: $15 Generic / $55 T2 / $85 T3 ( After Ded .)
20% Hospitalization
20% Outpatient Surgery
20% Inpatient Surgery ( After Deductible )
$6,300 Out of pocket maximum (2 max)

Trio HMO: Hottest HMO plan in CA!
www.TrioHMO.com

Meet Marc Harris
Your Local Certified Insurance Agent

I have been helping clients since 1998 and was
one of the first agents to get certified with
Covered California and the CoveredCA.com
Exchange. After reviewing the Blue Shield Trio ACO HMO options for this years open enrollment, I have concluded that they are going through a huge restructure and are unsure of their operations for this coming year. Some of our clients have seen upwards of a 40% rate increase. What a "bait and switch" in my opinion. Ready to renew your policy? We can help you today! Complete our short Covered CA RENEWAL FORM and someone will contact you.

BLUE SHIELD TRIO ACO HMO Info / Facts:
Founded in 1939 (78+ Years Ago)

Valued at $17 Billion (in 2014) 2016 Financials
# of Employees: 6,800 (4 million members)
Privately Held: Non-Profit Health Plan
BBB Rated: NR (Click Here) - Started 8/31/1993
Wiki Link:Blue Shield of CA Trio ACO HMO FAQs
website: BlueShieldCA.com
Customer Service Phone: (855) 836-9705
Payment Phone: (800) 393-6130 $100 Fitbit Credit
In-Network: Find a HOSPITAL / DOCTOR Search
Brochure Download: Blue Shield Trio ACO HMO
2022 Plans-at-a Glance Summary

Notes

(Advantages & Disadvantages):
- PROS: Solid HMO with very strong growing network
- Lower monthly premiums compared to other carriers.

- Average rate increases only 3% / Year vs others at 20%
- Shield Concierge available (7am - 7pm) 844-250-2873
- TelaDoc Video or Phone Dr. visits - $5 copay
- General / Psychiatry / Etc. (8am - 5pm) 800-835-2362
- ACOs have saved members $440+ Million (see video below)

- CONS: No Blue Card out-of-state network like the PPO
- Smaller HMO network vs the large PPO network .
- Must get a referral, but your Concierge can do it for you .

- All of the above is just our honest opinion.

Blue Shield Trio HMO:ACOs (Accountable Care Organizations) have saved over $440 Million to Members and Employers!

Click a carrier below for company details:

ANTHEM BLUE CROSS
BLUE SHIELD OF CA - PPO
BLUE SHIELD OF CA - TRIO ACO HMO
HEALTH NET
KAISER
LA CARE COVERED
MOLINA HEALTHCARE
OSCAR
SHARP

Health Plan Summary:
Platinum 90 - $0 Deductible

$15 Dr. Visit Copay / $30 Specialist

$15 Urgent Care $150 ER Visit

$15 Lab / $30 X-ray
Rx: $5 Generic / $15 Tier 2 / $25 Tier 3

10% Outpatient Hospitalization
10% Outpatient Surgery

10% Inpatient Hospitalization

$4,500 Out of pocket maximum (2 max)

Gold 80 - $0 Deductible
$35 Dr. Visit Copay / $65 Specialist
$35 Urgent Care $350 ER Visit
$40 Lab / $75 X-ray
Rx: $15 Generic / $55 Tier 2 / $75 Tier 3
20% Hospitalization
20% Outpatient Surgery
10% Inpatient Surgery
$8,200 Out of pocket maximum (2 max) Silver 70 - $3,700 Deductible / $10 Rx
$35 Dr. Visit Copay / $70 Specialist
$35 Urgent Care $400 ER Visit
$40 Lab / $85 X-ray
Rx: $16 Generic / $60 Tier 2 / $90 Tier 3 ( After Ded .)
20% Outpatient Hospitalization
20% Outpatient Surgery
20% Inpatient Hospitalization ( After Ded .)
$8,200 Out of pocket maximum (2 max)

Bronze 60 - $6,300 Deductible
$65 Dr. Visit Copay (3) visits / $95 Specialist (3) visits
$65 Urgent Care (3) visits
$40 Lab / X-ray not covered until meet deductible
Rx: $15 Generic / 40% Tier 2 / 40% Tier 3 ( After Ded. )
40% Hospitalization ( After Deductible )
40% Outpatient Surgery ( After Deductible )