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Health plan documents
Effective January 1, 2026
Family
Explore your plan options

Every Blue Shield plan is designed to help you discover the healthiest version of yourself. Choose from the options below to get started on your path to better health.

Medical plans

Custom Trio HMO Per Admit 20-500 01-26 SOB P4
+ Enhanced Rx $10/20/35 with $0 Pharmacy Deductible
+ Chiropractic and Acupuncture Benefits Additional Coverage

Our Trio HMO plan is typically more affordable than other plans. It features a select network of local providers who closely coordinate your care and a concierge service to help you with everything from benefit questions to scheduling doctor’s appointments. When you enroll in the Trio 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).

To enroll in the Trio HMO plan, you must live or work within the Trio service area.

Custom HMO Per Admit 20-500 01-26 SOB P43515
+ Enhanced Rx $10/20/35 with $0 Pharmacy Deductible
+ Chiropractic and Acupuncture Benefits Additional Coverage

With our Access+ HMO plan, you will only pay a fixed copayment for most services. You'll also be asked to select a primary care physician (PCP) to coordinate your care and refer you to specialists and hospitals within their medical group.

Custom PPO Combined Deductible 20-750 90-70
+ Enhanced Rx $10/20/35 with $0 Pharmacy Deductible

Our PPO plans offer broad physician and hospital networks, with the flexibility to see any doctor in or out of the plan’s network. PPO plans may include a deductible (amount paid before insurance kicks in), copayment (a set amount paid for a visit) or coinsurance (a percentage of the cost of a visit). Staying in-network typically means lower out-of-pocket costs than choosing to go out of network.

Custom PPO Savings Two-Tier Embedded Deductible

High-deductible health plans offer lower monthly premiums than our other PPO plans, but have a higher deductible. These plans qualify you for the option of opening a tax-advantaged HSA account to help save and pay for qualified medical expenses. Money added to an HSA is yours to keep and there is no use it or lose it penalty.

Dental plans

Custom Smile Spectrum Premier Plus 25 2000 LifetimeOrtho2000 U80

Having dental coverage offers much more than professional cleanings and cavity checks, as dentists can detect and treat gum disease which is linked to other health problems. With our Dental PPO plans, you have the flexibility to access services through both network and non-network providers, although you'll usually pay less when you use network providers. You may have to meet your plan's deductible for some services, and you may have a calendar year benefit maximum. Many Dental PPO plans also include orthdontic coverage. You dental provider can request a pre-treatment estimate to find out how much your plan will pay.

Custom Smile Spectrum Premier Plus 50 1500 LifetimeOrtho1500 MAC

Having dental coverage offers much more than professional cleanings and cavity checks, as dentists can detect and treat gum disease which is linked to other health problems. With our Dental PPO plans, you have the flexibility to access services through both network and non-network providers, although you'll usually pay less when you use network providers. You may have to meet your plan's deductible for some services, and you may have a calendar year benefit maximum. Many Dental PPO plans also include orthdontic coverage. You dental provider can request a pre-treatment estimate to find out how much your plan will pay.

Resources
Health programs and services
Discover all your care options

From routine checkups to emergencies and everything in between, we give you convenient access to a quality network of healthcare providers.

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Acupuncture services

Visit any participating acupuncturist in the American Specialty Health Plans of California, Inc. (ASH) provider network without a referral from your PCP.

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BlueCard and Away From Home Care for HMO plans

As a Blue Shield of California HMO member, you can take your healthcare benefits with you when you’re away from home. You are covered for emergency and urgent care services across the United States and around the world through the BlueCard® and Blue Shield Global Core programs.

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BlueCard and Away From Home Care for PPO plans

Through the BlueCard® and Blue Shield Global Core programs, you have access to care across the United States and urgent and emergency care around the world. You can receive urgent or emergency care from any provider. However, using a BlueCard provider can be more cost-effective.

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Chiropractic services

Visit any participating chiropractor in the American Specialty Health Plans of California, Inc. (ASH) provider network without a referral from your PCP.

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Health savings account (HSA)

An HSA offers a useful way for you to save for medical expenses.

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LifeReferrals 24/7

Experienced professionals are ready to help you with personal, family, and work issues at any time. Learn more by logging in to blueshieldca.com. For more information, call LifeReferrals 24/7 toll-free, anytime, at (800) 985-2405.

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Mental health and substance use care

You have access to virtual, in-person, and inpatient care to support your behavioral health. Beginning January 1, 2026, Blue Shield will directly manage the behavioral health benefit for all of our California members, including those receiving ABA services. You can use the Find a Doctor tool to look for therapists, psychologists, and other types of providers. Be sure to select the correct year for your coverage.

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Mobile app

View your ID card, search for doctors, track your claim information, understand your benefits and more.

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NurseHelp 24/7

Registered nurses are available to answer your health questions at any time, every day.

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Preventive care

Take charge of your health. Find out what screenings, services, and immunizations are recommended for you and your family.

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Shield Concierge

Get support managing your health needs for a wide range of conditions from a team specially trained on the specific health benefits and programs available to you. You’ll also receive personalized service for everything from finding a doctor to understanding benefits and claims.

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Shield Support

Get support managing your health needs for conditions such as diabetes, depression, chronic pain, cancer and others. Services include personalized health coaching, care plan development, provider coordination and more.

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Teladoc Health

Speak to a licensed doctor or mental health professional online, via a mobile app or phone. You have a $0 copay per consult.

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Wellness Discount Programs

Get help saving money and living healthier with a wide range of discount programs* including fitness club memberships; acupuncture, chiropractic services and massage therapy; eye exams, frames and contact lenses; and LASIK surgery

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Wellvolution

This program offers in-person programs and online programs to to help you achieve your well-being goals.

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Wellvolution.com

Join the Wellvolution®: Set your own health goals, invite your family and friends to support you, and take your programs on the go, on any device.

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Pharmacy benefits
Getting started with Amazon Pharmacy

Skip traditional pharmacy lines, enjoy upfront pricing, and easily order medications online with Amazon Pharmacy.

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Contact us

Trio HMO Plan

Phone: (855) 829-3566

7 a.m. to 7 p.m. PST, Monday through Friday

All Other Plans

Phone: (888) 256-1915

8 a.m. to 5 p.m. PST, Monday through Friday


Member Services

Phone: (855) 599-2655

8 a.m. to 5 p.m. PST, Monday through Friday


Dental Member Services

Phone: (888) 702-4171

8 a.m. to 5 p.m. PST, Monday through Friday


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