2023 Individual and Family Plan Information
In-Home Medical Visits for Blue Shield Members
2023 HMO plans
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2022 Plan Information
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Blue Shield adds Chiropractic and $0 Telemedicine
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COVID-19 update: Cost-sharing waivers extended through January 31, 2021 for COVID-19 treatment
As the fight against COVID-19 continues, Blue Shield of California is extending cost-sharing waivers for co-payments, coinsurance, and deductibles for COVID-19 treatment through January 31, 2021.
The extension of cost-sharing waivers applies to the following plan types:
- Fully-insured plans and IFP plans
- Plans purchased through Covered California
Covered services include any treatments for COVID-19 from doctors, hospitals, and other healthcare professionals in a plan’s network from March 1, 2020 through January 31, 2021. Providers must use proper diagnosis and procedure codes related to COVID-19 for Blue Shield to waive member deductible, copay, and coinsurance liability for treatment.
As of January 1, 2021, CVS Health became Blue Shield’s pharmacy vendor and handles all related services without impacting benefits, formulary, or the pharmacy network.
As a result of this vendor change, all members received new medical ID cards (mailed or electronic) effective January 1, 2021 and received an email notification when their new medical ID card is available. If a member has selected electronic delivery of their digital medical ID card, then they will access their updated digital medical ID card on blueshieldca.com. Everyone else received printed medical ID cards in the mail prior to January 1, 2021. Visit the resource page to help support your clients with these changes.
Medical ID cards go digital in 2021
In October, we expanded our Go Paperless initiative by offering digital medical ID cards for members who opt in for paperless electronic communication. Digital medical ID cards contain the most up-to-date information and are easily accessible at blueshieldca.com. Members can also use their mobile device to download the Blue Shield of California mobile app on the App StoreSM or Google PlayTM.
- The impacted members include:
- All off-exchange applicants who applied in 2020 and 2021
- All members on autopay
- All members who have registered for Teladoc
- Members who opted into electronic delivery between 2018 and October 2020 received digital medical ID card effective January 1, 2021. Members can access their medical ID cards for individuals and the family through the online portal whether they opted for paperless or not.
- Members who selected paper delivery as their preference for medical ID card continue to receive printed medical ID cards.
- Dental and vision products: new and existing members continue to receive printed ID cards for dental plans through the dental carrier. For vision plans, members do not need ID cards and can have providers confirm through mesvision.com/providers or call (800) 877-6372.
- Members who would like a printed medical ID card may request through the Blue Shield member portal at their convenience.
October 30, 2020
Blue Shield of California continues to grow its Trio HMO network in Southern California. We are happy to share a new addition in the Inland Empire and remind you about other Trio HMO additions we previously announced in Los Angeles, Riverside, San Bernardino, and Ventura Counties effective January 1, 2021. This applies to all lines of business that offer Trio HMO.
Allied Pacific IPA has added Alpha Care Medical Group to our Trio HMO network. Allied Pacific IPA, founded in 1992, is committed to providing quality and patient-centered medical care through an extensive and accessible network of healthcare professionals. Alpha Care adds another 102 physicians in the Inland Empire.
PrimeCare will now include San Bernardino Medical Group, PrimeCare of San Bernardino, PrimeCare of Redlands, and PrimeCare of Hemet Valley to our Trio HMO network. The addition of these medical groups adds over 50 additional physicians in the Inland Empire.
PIH Health is a nonprofit, regional healthcare network that serves approximately 2.5 million residents in Los Angeles County. The fully integrated network is comprised of PIH Health’s medical group and three hospitals in the cities of Los Angeles, Whittier and Downey. PIH Health adds network depth to the south and east Los Angeles area with 390 full time physician providers, plus 300 more physicians in their affiliated network.
Valley Care IPA joins the Trio HMO network in Ventura County with 106 affiliated primary and specialty care physicians. Established in 1994, Valley Care IPA’s goal is to provide local families with a choice of physicians practicing throughout Santa Paula, Fillmore, Camarillo, Oxnard, Ventura, and neighboring communities.
Chiropractor benefits available for Silver 1950 PPO and Silver 2600 HDHP PPO plans as of Jan 1, 2021
We are the first off-exchange health plan to offer embedded chiropractic services to members through the American Specialty Health (ASH) network with Silver 1950 PPO and Silver 2600 HDHP PPO plans. Benefits include:
- $15 copayments for Silver 1950 PPO
- 35% coinsurance for Silver 2600 HDHP PPO
- Both plans have an annual limit of 15 visits
Blue Shield Provider Search Tool
- Make sure to select the correct year and plan type before searching for a provider such as a doctor or hospital.
Exclusive PPO Network statewide
All Blue Shield of California individual and family plans will be Preferred Provider Organization (PPO) types that allow members to receive services from providers outside of the new Exclusive PPO Network. All plans offered through Covered California will adhere to the 2016 Standard Benefit Design. The same plans will be offered off-exchange directly from Blue Shield for individuals and families who do not qualify for the tax credits. In addition, Blue Shield of California will offer three non-standard benefit design plan in Silver and Bronze metal levels off-exchange.