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Health plan information
Learn about your health benefits
Access+ HMO plan

Plan highlights

The Access+ HMO® plan is affordable and predictable – you pay only the copayment for most covered services like doctor visits, urgent care and emergency care. Your primary care physician (PCP) coordinates all your care as well as refers you to specialists and hospitals within their medical group/Independent Practice Association (IPA).

When you enroll in the HMO plan for the first time, you must choose a PCP for yourself and your covered dependents. Each member of your family can choose a different physician and medical group/IPA.
Trio HMO plan

Plan highlights

Trio HMO is made up of a network of local doctors, specialists and hospitals that work closely together to coordinate your care. The goal of Trio HMO is to ensure that all aspects of your care are more connected to help improve your overall well-being, whether it be managing a chronic disease or reducing your stay at a hospital. Through this coordination, care is delivered more efficiently, resulting in lower monthly premiums than our Access+ HMO® plan.

To enroll in Trio HMO, you and your eligible dependents must enroll in the same plan and you must also live or work within the Trio HMO service area. Visit blueshieldca.com/x for a listing of the Trio service areas.

When you enroll in Trio HMO for the first time, you must choose a primary care physician (PCP) for yourself and your covered dependents. Each member of your family can choose a different physician and medical group/Independent Practice Association (IPA).
Access+ HMO SaveNet plan

Plan highlights

Our Access+ HMO® SaveNetSM plan offers the same benefits as the Access+ HMO plan. The only difference is that your monthly premiums are lower than the Access+ HMO® plan, and you will need to see providers in the Blue Shield Access+ HMO SaveNet Network.

To enroll in the SaveNet HMO plan, you and your eligible dependents must enroll in the same plan and you must also live or work within the SaveNet HMO service area. Visit blueshieldca.com/x for a listing of the SaveNet service areas.

When you enroll in the SaveNet HMO plan for the first time, you must choose a primary care physician (PCP) for yourself and your covered dependents. Each member of your family can choose a different physician and medical group/Independent Practice Association (IPA).
Local Access+ HMO plan

Plan highlights

Our Local Access+ HMO® plan offers the same benefits as the Access+ HMO® plan. The only difference is that your monthly premiums are lower than the Access+ HMO plan, and you will need to see providers in the Blue Shield Local Access+ HMO Network.

To enroll in the Local Access+ HMO plan, you and your eligible dependents must enroll in the same plan and you must also live or work within the Local Access+ HMO service area. Visit blueshieldca.com/x for a listing of the SaveNet service areas.

When you enroll in the Local Access+ HMO plan for the first time, you must choose a primary care physician (PCP) for yourself and your covered dependents. Each member of your family can choose a different physician and medical group/Independent Practice Association (IPA).
Exclusive Provider Organization (EPO) plan

Plan highlights

With the EPO plan, you'll choose from PPO physicians and hospitals, but won't have to pay deductibles or coinsurance. Except for emergencies, you are not covered if you get medical treatment by non-network providers. For some services, Blue Shield may require that you use a specific network provider.
Shield Spectrum Preferred Provider Organization (PPO) plan

Plan highlights

With the Shield Spectrum PPOSM plan, you can see any doctor you choose for most services. You can also self-refer to specialists. You will usually pay less for services that are provided by PPO network providers.

For most services, you will need to meet the plan’s deductible before Blue Shield begins coverage. Once your deductible is met, you’ll pay a copayment or coinsurance for most services and your out-of-pocket costs will be based on whether you see network or non-network providers. You will usually pay less when you use network providers.
Savings Plus PPO plan with HRA highlights

Plan highlights

With the Savings Plus PPOSM plan, you can see any doctor you choose for most services. You can also self-refer to specialists. You will usually pay less for services that are provided by PPO network providers. The plan is complemented by a health reimbursement arrangement (HRA)* that is funded 100% by [client name]to help you pay for qualified medical expenses. You contribute nothing. For << year>>, <<client name>> is contributing <<$X>> per individual or <<$X>> per family. To learn more, visit healthequity.com/bsc.
Savings Plus PPO plan with HSA highlights

Plan highlights

With the Savings Plus PPOSM plan, you can see any doctor you choose for most services. You can also self-refer to specialists. You will usually pay less for services that are provided by PPO network providers.

The plan is paired with a federal tax-free health savings account (HSA)* to help you save money. The HSA works a lot like a savings account. You contribute pre-tax dollars and use them to pay for your deductible and qualified out-of-pocket medical expenses. For more information, visit healthequity.com/bsc.
Tandem PPO plan

Plan highlights

The Tandem PPO plan offers affordable costs, through a smaller network of PPO providers, and the flexibility to see any doctor you choose for most services. You can also self-refer to specialists.

When you enroll in the Tandem PPO plan for the first time, you must choose a Primary Care Physician (PCP) for yourself and your covered dependents. Each member of your family can choose a different physician and medical group/IPA. As a member, you will benefit from having a personal relationship with a PCP who will work with you every step of the way to ensure you are receiving the right care.
Point of Service (POS) plan

Plan highlights

With the Added Advantage POSSM Plan, you have freedom to receive care for covered services from Blue Shield’s HMO and PPO providers as well as non-network providers. The plan combines the predictable out-of-pocket costs of an HMO with the flexibility of a PPO when you need it.

When you enroll in the POS plan for the first time, you must choose a primary care physician (PCP) for yourself and your covered dependents. Each member of your family can choose a different physician and medical group/ Independent Practice Association (IPA).