If you are thinking about switching to a Blue Shield medical plan available through Covered California, read through the tips below. You can also download this quick checklist to help you stay organized when switching to your new Blue Shield medical plan through Covered California.

We're here to help, if you have any questions call customer service at (855) 836-9705

Before you make the decision to purchase a plan through Covered California, consider the following

Finding a comparable plan

There are 4 Silver-level plans that can be purchased directly from Blue Shield and not through Covered California (and, as a result, are not eligible for premium assistance):

  • Silver 70 Off Exchange PPO or Trio HMO plans
  • Silver 1950 PPO plan
  • Silver 2600 HDHP PPO plan – a high-deductible health plan that is Health Savings Account (HSA) compatible

What is the difference between the Silver 70 plans through Covered California and the plans I can purchase directly from Blue Shield?

A premium surcharge is applied to the Silver 70 plan through Covered California. The total monthly premium may be less for Blue Shield’s Silver 70 Off Exchange PPO or Trio HMO plans which are nearly identical to the Silver 70 plans available through Covered California. The only difference between the Silver 70 plans is that you would pay sllghtly more for emergency medical transportation with the Off Exchange plan. If you are eligible for financial assistance, however, what you pay for the plan could be less through Covered California.

You should compare other Blue Shield plans that are eligible for premium assistance. You can also contact your broker or call a Customer Care Representative who can help you compare benefits and rates.

Opportunity to purchase a higher metal plan with more benefits

If you currently have a plan direct from Blue Shield and you cannot find its Blue Shield equivalent through Covered California, you may want to consider purchasing a higher metal plan with more benefits. For example, if you have a Silver 1950 plan, you may find that for a few dollars more, you can purchase a Blue Shield Gold 80 plan through Covered California to take advantage of the premium assistance and receive more benefits including a lower deductible. 

Provider availability

Make sure that your current preferred provider is available for any plan you are considering. 

Our Trio HMO and Exclusive PPO networks are the same whether you purchase a Blue Shield plan direct from us or through Covered California. If you choose the same plan through Blue Shield or Covered California, you will have access to the same provider network. 

However, when changing plan types, such as changing from a PPO plan to a Trio HMO plan, you will want to make sure that your preferred provider is available in your new plan’s network because there are differences between each plan type’s network. 

We make efforts to ensure that our list of providers is current and accurate. However, because providers leave networks from time to time, this list is subject to change, and you are encouraged to check with the provider before using their services.

Lastly, make sure you enter your provider information on the Covered California website to ensure you will still have access to your preferred providers. 

Drug formulary 

Make sure that the drugs you currently are taking are covered under any new medical plan you are considering. If you choose to keep the same Blue Shield plan but purchase through Covered California, you will have access to the same drug formulary (Standard drug formulary) for individual and family plans (IFP).  

Keep your Blue Shield dental plan, vision plan,1 or life insurance plan1 with Blue Shield

Even if you decide to purchase a new medical plan through Covered California, we recommend keeping your Blue Shield dental plan, vision plan, or life insurance plan. You can keep those plans directly with Blue Shield. 

When you go online to Covered California to enroll in your new medical plan, you will be given the opportunity to purchase a dental plan. You can just skip that section and keep your Blue Shield dental plan. Just continue to pay your bills to remain covered.