Shop 2021 health plans | Blue Shield of CA

MAKE THE MOST OF YOUR HEALTHCARE.

Open enrollment is November 1st through January 31, 2021, and your health is more important than ever. Explore our plan options and feel confident about the next step in your healthcare journey.

Do you need immediate 2020 coverage?

MAKE THE MOST OF YOUR HEALTHCARE.

Open enrollment is November 1st through January 31, 2021

Do you need immediate 2020 coverage?

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Here's where to start:

Learn about the difference between HMO and PPO plans.

PPO plans overview

PPO plans

Preferred provider organization

Care on your terms

  • Get primary, urgent, or emergency care statewide

     
  • Preventive care covered at 100%

     
  • Connect with doctors inside or outside the network

     
  •  
Learn more
 
HMO plans

Health maintenance organization

Guided care with your doctor

  • Access a quality network of providers

     
  • Preventive care covered at 100%

     
  • Feel protected with emergency care inside and outside your network

     
  •  
Learn more

PPO PLANS

Care on your terms

Preferred provider organization

Enjoy the flexibility to see doctors in a larger network and ability to customize your care.

Get primary, urgent, or emergency care statewide
Preventive care covered at 100%
Connect with doctors inside or outside the network

*HMO not available in all areas

HMO PLANS

Guided care with your doctor

Health maintenance organization

Partner with a doctor in your local area to coordinate your care at lower costs.

Access a quality network of providers
Preventive care covered at 100%
Feel protected with emergency care inside and outside your network

Which plan is right for you?

Here are the details about each plan to help make your decision.

PPO plans overview

Here are the details about our PPO plans to help make your decision.

Trio HMO
PPO
What you pay per month (premium) 1
lower premium
medium premium
See a specialist without a doctor referral
yes
In-state doctors and hospitals that accept your insurance
17,902 doctors 303 hospitals
56,212 doctors 329 hospitals
Emergency care available worldwide
Non-emergency care access
Local
yes
yes
California
yes
yes
United States
What you pay per visit 2
lower premium
medium premium
Virtual doctor and telehealth appointments 3
yes $0 copay
yes $0 copay
Tax-savings options to help pay for care 4
yes
Preventive care covered at 100%
yes
yes
Access to a wellness platform to manage your health
yes
yes
Additional support & Benefits
24/7 access to registered nurses, doctors, and mental health support
yes
yes
Dedicated support line to help you navigate your care (Shield Concierge)
yes
Discounts at local business 5
yes
yes
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Choose the level of coverage that's right for you

Each plan includes the same benefits, but your cost depends on how you use your plan.

 

Platinum

You’ll pay a high monthly rate for your plan, and pay a low amount when you need care.

Great for those who see a doctor often

We pay 90% of covered medical expenses

$0 deductible

 

Gold

You’ll pay a little more each month for your plan, and pay less when you get care.

Great for those who see a doctor often

We pay 80% of covered medical expenses

$0 deductible

 

Silver

You’ll find an affordable balance between your monthly premiums and the cost when you see a doctor.

Great for those who want to be prepared for an emergency

Moderate deductible

We pay 70% of covered medical expenses after you pay the deductible

 

Bronze

You’ll pay a low amount each month for your plan, and pay a high cost share when you get care.

Great for those who want coverage in case of emergencies but don’t expect to see a doctor often

Highest deductible

We pay 60% of covered medical expenses after you pay the deductible

 

Platinum

You’ll pay a high monthly rate for your plan, and pay a low amount when you need care.

 

Gold

You’ll pay a little more each month for your plan, and pay less when you get care.

 

Silver

You’ll find an affordable balance between your monthly premiums and the cost when you see a doctor.

 

Bronze

You’ll pay a low amount each month for your plan, and pay a high cost share when you get care.

Learn more about health insurance Show all FAQs

  • How does health insurance work?

    A health insurance policy determines the types of medical services or benefits you are covered for, which doctors you can see, and what hospitals you can visit. Your plan also determines what you pay for care and services. 

    After purchasing a health plan, you can then visit a doctor or hospital in the Blue Shield of California network. A network is a group of doctors, hospitals, and healthcare providers that work with a health plan like Blue Shield. That means you only have to pay a certain amount for healthcare services instead of the full cost. By using in-network doctors and hospitals, you can keep your costs lower. 

    Health insurance is for preventive and event-based care – meaning you don’t have to wait until you’re sick to see a doctor. Preventive services like annual exams and flu shots are available to you at no additional cost. 

     

  • What do I pay monthly?

    You’ll pay a fixed monthly rate for your health insurance policy. The amount depends on the plan you choose, where you live, and the age of each person on the policy. The lower your plan’s monthly rate, the more you typically pay when you see the doctor, and vice versa. Identifying how often you see a doctor can help you choose the right plan for you.

    Depending on your household size and income, you may be eligible for financial assistance through Covered California to lower your plan’s monthly rate or even your costs for medical care.

     

  • What do I pay when I see a doctor?

    Your bill for visiting the doctor will depend on the reason for your appointment and your plan’s benefits. Some services have a copay (a fixed dollar amount) and other services have coinsurance (a fixed percentage amount). When you pay a copay or coinsurance, Blue Shield of California will pay the rest of the charges for your visit. You should check to see if your health plan has an annual deductible, which is the amount of money you pay for services before the coinsurance and health plan begins paying for them. A high deductible could affect what you pay at each doctor’s visit.

    To protect you and your family from unexpected costs, most plans have an annual out‑of‑pocket maximum. Once you reach the out-of-pocket maximum, your health plan covers 100% up to the allowed charges for most covered medical services.

  • Copayment

    A fixed amount you pay for benefits such as doctor’s visits or any wellness services. This is usually after you’ve met your deductible if your plan has one.

  • Deductible

    The amount you pay each calendar year for most benefits before Blue Shield begins to pay. Some benefits, such as preventive care, are covered before you meet your deductible.

  • Out-of-pocket maximum

    The most you are required to pay in combined deductible, copayment, and coinsurance amounts for all of the covered services each year.

Explore doctors and hospitals

It’s important to know which doctors and hospitals are included in your plan’s provider network before you choose a plan. Use our Find a Doctor tool to determine if your preferred doctors and hospitals are included in our PPO and/or Trio HMO networks.

Why Blue Shield?

Explore plans in my area

Get care from anywhere

Use Teladoc to connect with a national network of U.S. board-certified physicians, nurses, and mental health professionals by phone or video-chat, from the convenience of your home.

Explore plans in my area

Achieve your health goals

WellvolutionSM offers online and in-person health and wellness programs designed to support well-being and disease reversal, all for no extra charge.

Explore plans in my area

Enjoy a flexible network

You can access our high-quality network of doctors and hospitals and enjoy the freedom to choose from a variety of care options.

 

Looking for dental, vision, and life insurance coverage?

Good health includes your dental and vision health, too. We’ve got you covered with a variety of dental and vision plans, as well as individual life insurance and Accidental Death and Dismemberment Coverage*.

 

Dental coverage

Protect your smile with one of our PPO or HMO dental plans

 

Vision coverage

Vision plans starting at only $6.50 per month.

 

Life coverage

Protect your loved ones’ financial security.

Looking for dental, vision, and life insurance coverage?

 

Dental coverage

Protect your smile with one of our PPO or HMO dental plans

 

Vision coverage

Vision plans starting at only $6.50 per month.

 

Life coverage

Protect your loved ones’ financial security.

Common healthcare terms to know

The terms and acronyms for health coverage can be confusing. Here are some common ones to know:

Common healthcare terms to know

The terms and acronyms for health coverage can be confusing. Here are some common ones to know:

  • Allowed charges

    The approved amount Blue Shield will pay for a service or benefit. If your doctor charges more than what’s allowed by your health insurance policy, you may be responsible for the difference.

  • Benefits or covered services

    The medically necessary services and supplies covered by Blue Shield.

  • Coinsurance

    A fixed percentage of the cost of your services that you’re responsible for. This is usually after you’ve met your deductible.

  • Copayment

    A fixed amount you pay for benefits such as doctor’s visits or any wellness services. This is usually after you’ve met your deductible if your plan has one.

  • Deductible

    The amount you pay each calendar year for most benefits before Blue Shield begins to pay. Some benefits, such as preventive care, are covered before you meet your deductible.

  • HMO

    A health plan where you choose a primary care physician (PCP) who treats you regularly. This includes preventive visits and referrals to specialists. You’ll need to see only other doctors or specialists in your PCP’s medical group. There is no coverage for services received from doctors who are outside your PCP’s network. 

  • Network

    A group of providers – including hospitals, doctors, specialists and other healthcare providers – that have agreed with Blue Shield to provide benefits for a specified amount.

  • Out-of-pocket maximum

    The most you are required to pay in combined deductible, copayment, and coinsurance amounts for all of the covered services each year.

  • PPO

    A health plan in which members can choose to see any provider in the PPO provider network without a referral. Members also have the freedom to use non-network providers for most services if they are willing to pay a higher share of the cost.

Applying for 2020 coverage during Special Enrollment

Applying for 2020 coverage during Special Enrollment

Losing coverage

You’ve had a change in job status, your COBRA ended, or your employer changed coverage.

Change in household

Household changes include marriage, a new child, divorce, or the death of the person who was eligible for health coverage.

Change in residence

You became a permanent resident of California outside of open enrollment or you moved and gained access to new plans.

Change in eligibility

You qualified for financial help, returned from active military service, or were released from incarceration.

Turning 26

You turn 26 and are no longer eligible to stay on your parents' plan.
Shop 2020 plans now
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Disclosures

  1. The average premium of all Trio HMO plans for 2021 is lower than the average premium of all PPO plans.
  2. The average out-of-pocket cost of all Trio HMO plans for 2021 is lower than the average out-of-pocket cost of all PPO plans.
  3. Primary care and behavioral health consultations provided remotely via virtual doctor and telehealth appointments available through Teladoc.
  4. Blue Shield does not offer tax advice. For information or questions, consult a financial or tax advisor.
  5. Discounts are not covered services or benefits under a Blue Shield of California health plan.

* This is for informational purposes only. * Underwritten by Blue Shield Life & Health Company