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.
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Before you make the decision to purchase a plan through Covered California, consider the following
Finding a comparable plan
There are 5 plans that can be purchased directly from Blue Shield that are not available through Covered California and, as a result, are not eligible for premium help:
- Silver 70 Off Exchange PPO or Trio HMO plans
- Silver 1750 PPO plan
- Silver 2600 HDHP PPO plan – a high-deductible health plan that is Health Savings Account (HSA) compatible
- Bronze 7500 Trio HMO plan
However, there are other Blue Shield plans with similar benefits that you may want to consider and for which you will be able to use your subsidy.
What is the difference between the Silver 70 plans sold through Covered California and the plans I can purchase directly from Blue Shield?
Blue Shield’s Silver 70 Off Exchange PPO or Trio HMO plans are nearly identical to the Silver 70 plans available through Covered California. The only difference in benefits between the Silver 70 plans is that your cost share for emergency medical transportation is slightly more with the Off Exchange plan. However, if you are eligible for financial help, what you pay for the plan could be less through Covered California.
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 1750 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 help and receive more benefits including a lower deductible. If you are enrolled in the Bronze 7500 Trio HMO plan, you should consider one of our Silver Trio HMO plans.
Provider availability
Make sure that your current preferred provider is available for any plan you are considering. Especially when looking to change plans, ensure you will still have access to your preferred providers before you make that change.
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.
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. If you currently have a Blue Shield dental plan, you can just skip that section and keep your plan. Just continue to pay your bills to remain covered.