MULTI-PLAN_20_780A_C 09212020
* SilverSneakers is not available to Blue Shield Vital (HMO) Medicare Advantage Plan members. There is a 40% coinsurance for Blue Shield Medicare (PPO) out-of-network services.
† In accordance with state and federal governments and COVID-19 precautionary measures, Blue Shield of California and SilverSneakers do not encourage member participation at any gym facilities at this time. We encourage members to follow CDC and state guidelines.
SilverSneakers is a registered trademark of Tivity Health, Inc. SilverSneakers GO is a trademark of Tivity Health, Inc. © 2020 Tivity Health, Inc. All rights reserved.
Blue Shield of California Promise Health Plan complies with applicable state laws and federal civil rights laws and does not discriminate, exclude people or treat them differently, on the basis of race, color, national origin, ethnic group identification, medical condition, genetic information, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, mental disability or physical disability. Blue Shield of California Promise Health Plan is a health plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees.
ATTENTION: If you speak English, language assistance services, free of charge, are available to you. Call (855) 905-3825 (TTY: 711), 8:00 a.m. to 8:00 p.m., seven days a week. The call is free.
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-855-905-3825 (TTY: 711) de 8:00 a.m. a 8:00 p.m., los 7 días de la semana..
注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-855-905-3825 (TTY: 711) 每週七天辦公，早上8:00 點至晚上8:00 點。
You can get this document for free in other formats, such as large print, braille, or audio. Call Member Services at (855) 905-3825 (TTY: 711)
You can contact Customer Care at (800) 776-4466 (TTY: 711), 8 a.m. to 8 p.m., seven days a week, from October 1 through March 31, and 8 a.m. to 8 p.m., weekdays (8 a.m. to 5 p.m. Saturday and Sunday) from April 1 through September 30.
Blue Shield of California is an HMO, PPO and HMO-DSNP plan with a Medicare contract and a contract with the California State Medicaid Program. Enrollment in Blue Shield of California depends on contract renewal.
Blue Shield of California complies with applicable state laws and federal civil rights laws, and does not discriminate on the basis of race, color, national origin, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, or disability. Blue Shield of California cumple con las leyes estatales y las leyes federales de derechos civiles vigentes, y no discrimina por motivos de raza, color, país de origen, ascendencia, religión, sexo, estado civil, género, identidad de género, orientación sexual, edad ni discapacidad. Blue Shield of California 遵循適用的州法律和聯邦公民權利法律，並且不以種族、膚色、原國籍、血統、宗教、性別、婚姻 狀況、性別認同、性取向、年齡或殘障為由而進行歧視。
