Introducing a new kind of health plan

Virtual Blue is a virtual-first PPO (Preferred Provider Organization) plan. This means members do not need referrals to access care, whether virtual or in-person. When accessing virtual care from virtual-only providers (through the Accolade Care* website or mobile app), members do not pay a copay or coinsurance, and have access to unlimited virtual primary, specialty, and mental health care visits for $0. For in-person care, members can see providers in or out of the Virtual Blue plan’s PPO network at the applicable cost share based on their plan. Members can also access virtual-only and in-person care anywhere in the U.S., and urgent and emergency care while traveling outside the U.S.

Accolade Care provides Virtual Blue members access to virtual-only providers through the Accolade Care mobile app or by logging in to blueshieldca.com which will redirect them to the AccoladeCare website. Virtual care can also be accessed by phone.

No. Virtual Blue members can also access in-person care from the Virtual Blue plan’s PPO in-network or out-of-network providers for the applicable cost share. These in-person doctors may also offer virtual care visits; however, these services will also be subject to the applicable cost share.

You will be given an opportunity to select a personal Virtual Blue physician (also known as a Primary Care Physician). If you don’t select a personal physician, you will be matched with one. You will have no obligation to see your virtual physician and can continue to see an in-person physician if that is your preference. Members can change their personal Virtual Blue physician at any time.

Yes, you can continue to see your existing in-person doctors and pay the applicable in-network or out-of-network cost share, based on your plan’s benefits. The exact cost share will depend on whether your doctor is in or out of the Virtual Blue plan’s PPO network. To find out whether your existing doctor is in-network, visit Find a doctor.

Virtual Blue differs from basic telehealth in several ways. First, Virtual Blue members select their virtual physicians on the criteria that matter to them and can continue to see those physicians on an ongoing basis for virtual preventive, urgent, and chronic care. This is different than traditional telemedicine where you typically see a different physician each time.

Second, Virtual Blue members can choose same-day access to a virtual PCP, who may or may not be their selected physician. In addition, members have access to a virtual health coach, care coordinator, and nurses who support members with health improvement, chronic condition management, and coordination of specialty care. The virtual care team also has access to claims, medical records, and other data that supports each member’s personalized care plans.

Third, Virtual Blue allows members to seek integrated virtual primary care, urgent care, chronic care, mental health, and specialty care through the Accolade Care mobile app or by logging in to blueshieldca.com which will redirect them to the AccoladeCare website.

As a Virtual Blue plan member, you will be connected to a virtual team of integrated primary, mental health, and specialty care professionals, plus an established in-person PPO network.

Virtual care services include:

• primary care, including pediatrics, family medicine, and internal medicine
• specialty care that includes 20 specialties
• integrated mental health care for members ages 4 and older, including access to psychologists, psychiatrists, licensed clinical social workers (LCSW), and marriage and family therapists (MFT)
• urgent care
• 24/7 medical support from physicians, as well as a team that includes a certified health coach, care coordinator, and nurses

Yes, the virtual-only care team reflects gender and racial diversity. Some physicians also speak more than one language in addition to English, such as Spanish, Mandarin, Farsi, and more. The team also includes doctors and nurses with expertise in areas such as sexual health screening, family planning, mental health issues, and transgender care.

No, there are no physical locations for any Virtual Blue virtual provider. However, members may see other Virtual Blue plan’s PPO in-network and out-of-network providers for in-person visits at the applicable cost share for their plan. To locate an in-person provider, members can visit Find a doctor.

Yes, Virtual Blue members will have access to patient reviews and physician biographies through the Accolade Care mobile app or website. Members can select physicians based on the criteria that are most important to them, including gender, race, years of experience, language spoken, and experience with diverse patient populations.

Virtual Blue members, ages 4+, can access unlimited mental health visits for $0 copays. Services include psychotherapy, psychiatry medication management, and therapy with mental health specialists, including Licensed Clinical Social Workers (LCSW), Marriage and Family Therapists (MFT), and psychiatrists and psychologists (including PhDs). Members may also seek in-person or virtual mental health services from the plan’s PPO in-network and out-of-network providers at the applicable cost share for their Virtual Blue plan.

Virtual Blue members can choose in-person care at their own discretion, or at the advice of a care professional. Your virtual care team can determine if any medical services cannot be provided virtually and will suggest when you should see an in-person provider, at the applicable cost share for your plan. You do not need a referral from the virtual provider to seek care from an in-network or out-of-network provider. Examples of medical services that cannot be provided virtually include some preventive screenings such as mammograms, lab work, skin procedures such as biopsies or abscess treatments, etc.

Virtual Blue members can find, select, and schedule their virtual provider through Accolade Care’s mobile app or by logging in to blueshieldca.com which will redirect them to the Accolade Care website. Members can also locate virtual or in-person providers by visiting Find a doctor and then choosing virtual care or in-person provider.

Members may book virtual visits with virtual providers in minutes by downloading the Accolade Care mobile app or by logging in to blueshieldca.com which will redirect them to the Accolade Care website. Virtual care can also be accessed by phone.

To schedule in-person care, the member’s virtual health coach can assist with booking the appointment or the member can book the appointment directly with the provider. As Virtual Blue is a PPO product, referrals are never needed for any care.

Yes, in-person providers may share notes with Virtual Blue’s virtual providers with the member’s consent.

The Vitals kit will include a blood pressure cuff, scale, and thermometer. Ideally, members will schedule a doctor’s appointment and take their vitals (height, weight, blood pressure, and temperature) prior to the visit. Members can also use the medical devices during their virtual appointment.

No, only the subscriber enrolled in this plan will receive Vitals Kit for no additional charge. The Vitals Kit can be shared with all members of your family. Please consult your physician on how to use these devices on yourself and family members.