Annual Out-of-Pocket Maximum
(includes deductible)
$3,000/single (2-member maximum)
Annual Deductible
$1,500/member
Inpatient hospital services, outpatient
Ambulatory Surgical Centers only
Office Visits
You pay $10
Professional Services
(other office visits, X-ray, lab, anesthesia, surgeon, etc.)
Unlimited office visits: you pay $10 per visit
Inpatient hospital — no charge
Hospital Inpatient/Outpatient
Inpatient — no charge after $1,500 deductible for non-emergency services
Outpatient — you pay 20% of negotiated fee after $1,500 deductible for non-emergency services
(for non-emergency services)
Emergency Services
Inpatient and professional services — no
charge when authorized by a medical group
within 48 hours of emergency care
Outpatient — you pay $100 emergency room
copayment plus 20%
Maternity
Professional Office Visit you pay $10 copaymentHospital – no charge after $1,500 deductibleOutpatient Hospital – 20% after $1,500 deductible.
Preventive Care
You pay a $10 copayment for specific health
maintenance services
Ambulance
You pay a $50 copayment unless admitted to
the hospital
Physical and Occupational Therapy; Chiropractic Services
You pay $10 per visit; limited to 60 consecutive days following illness or injury; no charge for inpatient services Chiropractic benefits with
medical group referral
Drug Benefits
(retail or mail order: 30-day supply)
Participating Provider
You pay $10 for generic and $30 for Brand drugs, plus a $250 deductible for Brand drugs
Non-Formulary:
Participating Provider: Generic 50%; Brand 100% of negotiated Fee Rate for Brand Name Drugs until the Brand Name Prescription Drug Deductible is
Non-participating Provider
You pay a $250 Brand deductible; then 50% of drug Limited Fee Schedule within California
Here at Santa Barbara Health Insurance Services we know that no web site
can substitute for courteous service from an experienced professional. Our staff
is always happy to help with your California health insurance, California dental
insurance, or term life insurance needs. Feel free to call us any time at (800)
765-1540.
FREE Health Quote
Testimonials...
"Santa Barbara Health Insurance helped us improve our health benefits and has saved us a significant amount of money. We highly recommend them."
- Renee Grubb, Co-Owner of Village Properties Realtors
"Rob and Steve at Santa Barbara Health Insurance have been thorough, professional, and very easy to work with. They helped us transition to
a Health Savings Account strategy which benefits our employees and our company."
- Dave Larson, Managing Partner at McGowan Gunterman CPA's
“The guys at Santa Barbara Health Insurance are always available to answer our questions and have given us great service. It is almost like
they are right next door.” - Scott Branch, Partner, Burnell, Branch, and Pester Architects.
“When I broke my wrist skateboarding, the Anthem Blue Cross Tonik plan that Rob set me up with really came through big and saved me from racking
up huge debts.”
- Peter Schick, Individual.
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Santa Barbara Health Insurance Services