EPO Plans

EPO Plans

Prescription drug options

Full EPO Plans Summary of Benefits Optional Benefits  Disclosures
Full EPO Zero Admit 20 English (PDF, 989KB)
Spanish (PDF, 169KB)

Hearing aid (PDF, 990KB)
Base infertility 50% (PDF, 994KB)
Additional infertility 50% (PDF, 994KB)
Additional infertility 80% (PDF, 994KB)
Additional infertility 95% (PDF, 994KB)

Spanish
Hearing aid (PDF, 753KB)
Base infertility 50% (PDF, 109KB)
Additional infertility 50% (PDF, 109KB)
Additional infertility 80% (PDF, 109KB)
Additional infertility 95% (PDF, 109KB)

 English (PDF, 25KB)
Full EPO Zero Admit 30 English (PDF, 1MB)
Spanish (PDF, 169KB)

Hearing aid (PDF, 990KB)
Base infertility 50% (PDF, 994KB)
Additional infertility 50% (PDF, 994KB)
Additional infertility 80% (PDF, 994KB)
Additional infertility 95% (PDF, 994KB)

Spanish
Hearing aid (PDF, 753KB)
Base infertility 50% (PDF, 109KB)
Additional infertility 50% (PDF, 109KB)
Additional infertility 80% (PDF, 109KB)
Additional infertility 95% (PDF, 109KB)

 English (PDF, 25KB)
Full EPO Per Admit 10-250 English (PDF, 1MB)
Spanish (PDF, 169KB)

Hearing aid (PDF, 990KB)
Base infertility 50% (PDF, 994KB)
Additional infertility 50% (PDF, 994KB)
Additional infertility 80% (PDF, 994KB)
Additional infertility 95% (PDF, 994KB)

Spanish
Hearing aid (PDF, 753KB)
Base infertility 50% (PDF, 109KB)
Additional infertility 50% (PDF, 109KB)
Additional infertility 80% (PDF, 109KB)
Additional infertility 95% (PDF, 109KB)

 English (PDF, 25KB)
Full EPO Facility Coinsurance 20-20% English (PDF, 1MB)
Spanish (PDF, 170KB)

Hearing aid (PDF, 990KB)
Base infertility 50% (PDF, 994KB)
Additional infertility 50% (PDF, 994KB)
Additional infertility 80% (PDF, 994KB)
Additional infertility 95% (PDF, 994KB)

Spanish
Hearing aid (PDF, 753KB)
Base infertility 50% (PDF, 109KB)
Additional infertility 50% (PDF, 109KB)
Additional infertility 80% (PDF, 109KB)
Additional infertility 95% (PDF, 109KB)

 English (PDF, 25KB)
Tandem EPO Plans Summary of Benefits Optional Benefits  Disclosures
Tandem EPO Zero Admit 20 English (PDF, 977KB)
Spanish (PDF, 169KB)
 

Hearing aid (PDF, 990KB)
Base infertility 50% (PDF, 994KB)
Additional infertility 50% (PDF, 994KB)
Additional infertility 80% (PDF, 994KB)
Additional infertility 95% (PDF, 994KB)

Spanish
Hearing aid (PDF, 753KB)
Base infertility 50% (PDF, 109KB)
Additional infertility 50% (PDF, 109KB)
Additional infertility 80% (PDF, 109KB)
Additional infertility 95% (PDF, 109KB)

 English (PDF, 25KB)
Tandem EPO Zero Admit 30 English (PDF, 977KB)
Spanish (PDF, 169KB)
 

Hearing aid (PDF, 990KB)
Base infertility 50% (PDF, 994KB)
Additional infertility 50% (PDF, 994KB)
Additional infertility 80% (PDF, 994KB)
Additional infertility 95% (PDF, 994KB)

Spanish
Hearing aid (PDF, 753KB)
Base infertility 50% (PDF, 109KB)
Additional infertility 50% (PDF, 109KB)
Additional infertility 80% (PDF, 109KB)
Additional infertility 95% (PDF, 109KB)

 English (PDF, 25KB)
Tandem EPO Per Admit 10-250 English (PDF, 977KB)
Spanish (PDF, 170KB)
 

Hearing aid (PDF, 990KB)
Base infertility 50% (PDF, 994KB)
Additional infertility 50% (PDF, 994KB)
Additional infertility 80% (PDF, 994KB)
Additional infertility 95% (PDF, 994KB)

Spanish
Hearing aid (PDF, 753KB)
Base infertility 50% (PDF, 109KB)
Additional infertility 50% (PDF, 109KB)
Additional infertility 80% (PDF, 109KB)
Additional infertility 95% (PDF, 109KB)

 English (PDF, 25KB)
Tandem EPO Facility Coinsurance 20-20% English (PDF, 977KB)
Spanish (PDF, 170KB)
 

Hearing aid (PDF, 990KB)
Base infertility 50% (PDF, 994KB)
Additional infertility 50% (PDF, 994KB)
Additional infertility 80% (PDF, 994KB)
Additional infertility 95% (PDF, 994KB)

Spanish
Hearing aid (PDF, 753KB)
Base infertility 50% (PDF, 109KB)
Additional infertility 50% (PDF, 109KB)
Additional infertility 80% (PDF, 109KB)
Additional infertility 95% (PDF, 109KB)

 English (PDF, 25KB)

 

Contact Us

  • Producer Services (800) 559-5905

    Employer Services (800) 325-5166

  • Blue Shield of California

    PO Box 272540

    Chico, CA 95927-2540

© California Physicians’ Service DBA Blue Shield of California 1999-2022. All rights reserved. California Physicians’ Service DBA Blue Shield of California is an independent member of the Blue Shield Association.

Health insurance products are offered by Blue Shield of California Life & Health Insurance Company. Health plans are offered by Blue Shield of California.