2021 Blue Shield Trio & PPO
CA Individual & Family

We’ve represented Blue Shield for 40 years and have been quite happy.   There is no charge for you to have our expertise as Blue Shield pays us.  It helps them too!

Check out the brochure to the right if you have a full size monitor or below if you are on a smart phone.  See the buttons to enroll, set a Zoom meeting or ask us a question.

 

 

Blue Shield - Get a quote & enroll. 
No extra charge for our services.

Blue Shield Quote & Enroll

Paper Application - BUT ONLINE is better. 

 

Blue Shield Authorized Broker Website
INSTANT QUOTES & Enroll
Blue Shield Authorized Broker Website – INSTANT QUOTES & Enroll

2020 Paper Application

Steve @ Blue Shield HQ

Steve at Blue Shield HQ

Appoint us as your broker - Covered CA ********* Direct

Blue Shield Provider Finder -
Dentists, Doctors & Hospitals

Blue Shield Provider Finder - Dentists

VIDEOS

Finding or changing MD
with Trio Plan VIDEO

 

How to use the Finding a provider tool above VIDEO

Our Web page with more detail on using provider finder

Understanding Your Plan pdf

Video - Understanding your plan

Nurse Help 24/7, Heal and Teladoc save on prescriptions ER vs. urgent care.
VIDEOS

 

Use your online account to review claims, copays or deductibles and take advantage of other member benefits.

Explanatory VIDEOS  on everything... from Blue Shield

 

Picking a PPO Primary Care Physician PCP – MD

PPO members for all Covered CA plans and maybe all? plans will now have a central point of contact PCP – Primary Care Physician, in the health system for receiving long-term, comprehensive, coordinated care for most health needs. PPO members are able to switch PCPs at any time. There is no action for members to take. Blue Shield will provide additional details on this new feature in the coming weeks.

Members of non-grandfathered PPO plans will continue to have the freedom to choose specialists and other providers – without referrals inside or outside the network – as they do now.

PPO Primary Care MD – member communication from Covered California


FAQ’s

Primary Care & PPO VIDEO 

Pick primary care even if on PPO

 

Blue Shield TRIO Plan Guide
PPO Plan Guide
Click link to see the pdf directly
Get Quotes & Subsidy Calculation

2020 Summary of Benefits

2020 Paper Rate Book

If any of the links don't work or require a password, just email us [email protected] for what you need

PPO Plans Summary of Benefits
Blue Shield Platinum 90 PPO English
Spanish

Important Legal Information booklet

Evidence of Coverage/Policy (EOC)
Visit blueshieldca.com/policies to download the forms.

Blue Shield Gold 80 PPO English
Spanish
 
Blue Shield Silver 70 PPO English
Spanish
 
Silver 70 Off Exchange PPO English
Spanish
 
Silver 1950 PPO (New for 2020) English
Spanish
 
Silver 2600 HDHP PPO (New for 2020) English
Spanish
 
Blue Shield Bronze 60 PPO English
Spanish
 
Blue Shield Bronze 60 HDHP PPO English
Spanish
 
Blue Shield Minimum Coverage PPO English
Spanish
 

Blue Shield offers  six Silver cost-sharing reduction plans through Covered California for clients whose income is between 138% to 250% of the federal poverty level (FPL). These plans are available only through Covered California, there is no extra charge to use an agent.

If any links require a password or don't work, just email us [email protected]

Cost-Sharing Reduction Plans Summary of Benefits
Blue Shield Silver 73 PPO English
Spanish

Important Legal Information booklet

Evidence of Coverage/Policy (EOC)
Visit blueshieldca.com/policies to download the forms.

Blue Shield Silver 73 Trio HMO English
Spanish
 
Blue Shield Silver 87 PPO English
Spanish
 
Blue Shield Silver 87 Trio HMO English
Spanish
 
Blue Shield Silver 94 PPO English
Spanish
 
Blue Shield Silver 94 Trio HMO English
Spanish
 

2019 Benefit Summaries  |  Dental Benefit Summaries  |  Vision Benefit Summaries

19 comments on “Blue Shield 2021 PPO & Trio

    • ACA/Obamacare pretty much made the coverage for all plans and all companies, exactly the same. It’s a function of Metal Levels, Platinum, Gold, Silver & Bronze. Silver 73, 87 & 94 are only available if your income is low. Get a quote to see.

      There are 10 essential benefits under ACA/Obamacare.

      CA has additional benefits

      ACA Obamacare Essential Benefits

      (A) Ambulatory patient services.
      (B) Emergency services.
      (C) Hospitalization.
      (D) Maternity (page 9 & 85) [but not infertility] and newborn care.
      (E) Mental health and substance use disorder services, including behavioral health treatment.
      NAMI Website , AB 88, CFR 156.115 (a) (3), “Federal Mental Health” Mental Health Parity Act 1996 2008 Final Rules

      (F) Prescription drugs.
      CFR 156.122

      (G) Rehabilitative and habilitative [learn or improve skills for daily living] services and devices. (American Academy of Reb 18 page paper)
      (H) Laboratory services.
      (I) Preventive and wellness services and chronic disease management.
      (J) Pediatric services, including oral and vision care. Blue Shield Individual Flyer Essential Health Benefits 5.2013 Group Essential Health Benefits (EBH) 42 USC 18022 SB 951
      Get Adult Dental & Vision Quotes – ONLINE Enrollment
      (H?) Cancer and other life threatening disease – clinical trials

      CA Essential Benefits
      Preventive services for children 16 and younger
      Mental health parity
      Autism care including behavioral health treatment
      Prescription drug coverage for contraceptives
      Maternity hospital stay
      Maternity: Inpatient hospital and ambulatory
      AIDS vaccine
      HIV testing
      Organ transplants for HIV
      Diabetes education, management and treatment
      Alpha feto protein testing
      Prosthetics for laryngectomy
      Reconstructive surgery
      Mastectomies and lymph node dissections
      Mammography
      Cervical cancer treatment
      Cancer screening tests
      Cancer clinical trials

      Prostate cancer treatment
      Osteoporosis treatment
      Surgical procedures for jaw bones
      Anesthesia for dental
      Conditions attributable to diethylstilbestrol
      Hospice (end of life) care
      Pain management medication for terminally ill
      Emergency response ambulance or ambulance transport services
      Medicare Coverage # 11021
      Phenylketonuria treatment
      Sterilization operations and procedures View the Affordable health ca.com page Assembly Bill 1453 (Monning) and Senate Bill 951 (Hernandez). View the California Health and Safety Code, section 1367.005

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