Contents
Cal Poly Pomona

Mental Health and Substance Abuse

image of Blue Cross logo and link to website

PERSCARE

1-877-737-7776

www.bluecrossca.ca

Group # KB010

Following are excerpts from the Evidence of Coverage (E.O.C.) Booklet, displayed for your convenience. Please refer to the E.O.C. for details or contact the plan directly.

The percentages shown below are member's costs.

Mental Health

PPO
Non-PPO

 


Inpatient
:

10%

40%

Outpatient:
10%
40%

Maximum Annual Co-Payment for all services

Applies only when using participating providers.

  • Member $2,000
  • Family $4,000

 

Link to EAP Home