Tonik Health Insurance Plans

Any Questions? Please Call 619-299-6000
What is Tonik?
What's Included?
What Doctors Accept Tonik?

Tonik is a popular PPO health insurance plan from Blue Cross of California. Don't worry, Tonik is popular for all age groups, as long as you are in good health, under 65 years of age, then Tonik may be right for you.

Three plans. Same all-around coverage: Preventive, emergency, Rx, eyes, teeth
(no maternity).

Basically there are 3 Tonik plans to choose from:

1. Thrill Seeker (AKA Tonik 5000)

2. Part-Time Daredevil (Tonik 3000)
3. Calculated Risk Taker (Tonik 1500)

The average price of Tonik for someone under 30 ranges from $77 - $164 per month, depending on the plan you pick, where you live, your age and your medical history. Rates are subject to change.

F.A.Q's:

What is covered when I visit my doctor?

Your office visit copay will cover the cost of professional services, like routine physical exams, preventive care, lab work and X-rays that you receive in your doctor’s office during the office visit.

Am I covered when I'm away from home?

Of course you're covered for emergencies. We wouldn't leave you high and dry if you leave California. No matter where you are in the United States, you're covered under the BlueCard program. Blue Card gives you access to doctors and hospitals in participating networks all across the United States. If you need medical services while you are traveling, call BlueCard at 800-810-BLUE. So you don't have to memorize the number, it will also be on your ID card. Please note: If you're traveling out of the country, BlueCard covers emergency services only.

Do I get vision coverage?

Yes. We want to help you see clearly (especially if you're spending a lot of time at a computer monitor). With Tonik, you not only receive a $50.00 medical reimbursement for vision services, you also get additional coverage through Blue View Vision. What's Blue View Vision? It provides you with access to eyeglasses and contact lenses from a big network of vision care providers. And with Blue View Vision benefits, you'll pay only $25 for most eyeglass lenses. And, every 24-month period, Blue Cross will kick in either $100 towards frames or $80 towards contact lenses. Beats the heck out of paying retail. Check out a Benefit Summary for more detailed information.

 

Coverage for:

Office visits
Emergency Room
Generic Prescriptions
Dental coverage
Vision benefits

Benefits:

All three plans offer $10 generic prescription drugs, low copays for doctor visits and $100 copays for the Emergency room.

The main differences between the plans are the annual deductible (ranges from $1500-$5000) and office visit copay (from $20-$40), and the monthly premium. For all of the details, please see the Tonik Plan Overviews.

The downside?

Please remember that there is no maternity.

No Name brand prescriptions.

Generic prescriptions only.

The Blue Cross Tonik application is all done online and takes about 10-15 minutes to complete.

Ready to Apply?

Most applications are approved by underwriting within 24 hours!

Key Insurance Terms:

PPO is what?

PPO stands for "Preferred Provider Organization". Which means if you want to get the biggest bang for your buck, you should go to one of the more than 42,000 doctors and 400 hospitals in the Blue Cross network. Shouldn't be too hard to do. Of course, you can go to any doctor or hospital you want, but it could get pretty expensive.

What's the difference between In and Out of Network?

The main difference is money, potentially lots of it. The Blue Cross network is made up of more than 42,000 doctors and 400 hospitals that Blue Cross has negotiated with to provide you with stellar care and services at a much lower cost to you. So if you go to any doctor or hospital not in the enormous Blue Cross network, you could pay a lot more.

What's a premium?

Basically, "premium" is the stuffy way to say how much you pay for your health insurance each month. You can also choose to pay your premium every other month, or every three months. If you don't want to risk getting dropped, make sure you get your payments in on time. Signing up for automatic checking account deduction is a real good way to make sure that doesn't happen. To switch to automatic bank withdrawl, call Blue Cross at (866) 333-4820.

What's a co-pay?

A co-pay is how much you pay for a doctor visit or other specified medical services. Depending on your plan, the amount for doctor visits ranges from $20-$40 each time.

What does Annual Out of Pocket (OOP) maximum mean?

Your annual OOP in-network is the most you'll have to pay within a calendar year for all of your covered medical bills, then the health insurance company pays the rest - as long as you use in-network doctors and hospitals. This amount varies depending on the plan you choose ($1,500, $3,000 or $5,000). Basically, meet your deductible - and you've reached your in-network OOP.

If you go outside the network, your annual OOP is much higher -- $10,000... so stay in the network.

 

Deductible: How much you'll pay each year before the health insurance company pays for services, like hospitalization.

Out-of-Pocket Maximum: the amount you pay after meeting your deductible.

 

 

Blue Cross of California has one of the largest PPO networks in California. Please visit: Provider Finder for local doctors in your area.

Copays for office visits, ER visits and prescription drugs do not apply toward the deductible/out-of pocket maximum. This is only an overview of the Tonik plan benefits.

For a complete listing of all benefits, limitations and exclusions, call 619-889-0889 to request a policy booklet.


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Copyright © 2006 John Tesoriero Authorized Agent, CA License 0E27104
 
 
 
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As a San Diego based insurance agency, we are located near Riverside county, Imperial County, Los Angeles County, and San Bernadino County. We can help anyone in California with insurance needs including the following zip codes and local community areas near our insurance agency:

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