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RENEW YOUR HEALTH COVERAGE

Renew today. Now is the time to decide if you want to keep your current plan or review other options and then change your plan. It’s easy to keep your current plan in 2021 — just continue to pay your monthly bill†.

If you want to make changes to your plan, please do so before December 15 for a January 1 effective date.

Open enrollment runs from October 1 through January 31, 2021.

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01

October

Early renewal begins.

Early open enrollment

Read important information that may affect your plan next year.

Review your 2021 benefits.
 

01

November

Open enrollment officially begins.

Open enrollment

Find out if you qualify for financial assistance.

Learn more: PPO vs HMO – which is right for you?
 

15

December

It’s not too late to renew. Keep your current plan in 2021. Or, make changes by December 15 for coverage that begins January 1, 2021.

Make changes by Dec 15

Avoid potential tax penalty from not maintaining coverage.

Enroll in the plans that support your total health.
 

31

January

Last day of open enrollment. Make sure you are enrolled in a medical plan for 2021!

Last day of open enrollment

Last day to make any changes for coverage beginning February 1, 2021.

After open enrollment ends, you must have a qualifying event to enroll in coverage during a special enrollment period (SEP).
 

How to stay covered

1

Keep your plan

To keep your plan, just continue paying your monthly bill.

Learn more about current plan

2

Explore plan types

Look at our plan options, including dental, vision and life insurance plans, for you to stay fully covered.

Explore more

3

Check for financial help

You may qualify for help to cover part or all of your premium.

Check to see if I qualify

Helpful information for 2021

Need to know more than what the topics below cover? Find your question in our Frequently Asked Questions

  • What should I expect during open enrollment?

    You have a small window every year – the open enrollment period – when you can enroll in a medical plan. You can renew your current plan, choose a new one, or make changes, such as adding dependents. When early renewals start on October 1, you can get an early start to shop and compare Blue Shield plan options and decide to keep your plan. The open enrollment period officially begins November 1.

    So, when we say “renew your health coverage,” we mean make the decisions to maintain coverage with a plan that is best for you and your family. 

  • Why it’s important to “Stay Covered” – Learn about the Individual Mandate

    Californians are required to be enrolled in and maintain minimum essential coverage throughout the year. This law is known as the individual mandate.

    In other words, if you do not have health coverage for 2021, you may have to pay more in taxes in 2022. Staying covered can help you to avoid this tax penalty.

    * Blue Shield does not offer tax advice. For information or questions, consult a financial or tax advisor.

  • Looking for financial help? You may qualify for premium assistance, the California Premium Subsidy, or both

    Premium assistance (federal tax credits and state subsidies) is available for eligible individuals with incomes at or below 138% of the Federal Poverty Level (FPL) and between 200 – 600% of FPL. The amount of premium assistance that Californians can qualify for depends on age, household income and size, and the cost of affordable healthcare coverage in their region. State and federal premium assistance are available only for medical plans purchased through Covered California.

    The California Premium Subsidy sets a limit on how much one pays for medical premium based on a percentage of annual income. Refer to Helpful Information for 2021 in your renewal booklet mailed to you for a reference chart. 

    • If you earn between 400 to 600% of the Federal Poverty Level (FPL), you may qualify for the California Premium Subsidy (state subsidy).
    • If you earn between 200 to 400% of FPL, you may be eligible for both federal (APTC) and state premium assistance and you may get an additional California Premium Subsidy to further lower your costs for coverage. 
    • If you make under 138% of FPL but are not eligible for Medi-Cal or Medicare, you may be eligible for the California Premium Subsidy.
       

    Use our subsidy eligibility calculator to find out if you might qualify for premium assistance and get an estimate of your potential premium assistance amount. If you find out you may be eligible, contact your broker to learn about your options. State and federal premium assistance are available only for medical plans purchased through Covered California.

  • COVID-19: Get up to date information and learn how to minimize your risk

    Learn all you can about getting tested and what your plan covers.  You should also be aware of how you can get medical care remotely  while staying safe and reducing exposure, especially if you fall within a high-risk group. To learn more about virtual care options – and for the most up-to-date information on what your plan offers – visit blueshieldca.com/coronavirus.

  • Information for our members who purchased plans through Covered California

    Whom to contact for help with your plan purchased through Covered California

    If you purchased your plan through Covered California, there are certain situations when you should contact Covered California and other situations when you should contact Blue Shield of California directly. Please review the list below to help you understand whom to call when you need help: 

     

    Contact Covered California at (800) 300-1506 or visit CoveredCA.com if you need to:

    • Update your address and contact information
    • Report any changes to your income
    • Update information such as citizenship and proof of residency
    • Make changes to your health coverage
    • Ask questions about financial assistance
    • Cancel your coverage
    • Request a copy of your Form 1095A

     

    Contact Blue Shield at the number listed on your ID card if you need to:

    • Ask a question about billing and payments
    • Learn more about benefits and eligibility
    • Ask about termination due to nonpayment and/or request reinstatement

     

    You can also log in to your online account at blueshieldca.com to:

    • Make a payment or check status on billing and payments 
    • Get an electronic version of your membership ID card, which you can also print
    • Get help finding doctors or other providers 
    • Find out how claims for services were paid 
    • Change primary care physician

     

    New for 2021: Family Dental Plans available through Covered California

    New for 2021, we are pleased to announce our Family Dental Plans that are now available exclusively through Covered California. With Blue Shield Family Dental PPO and HMO plans, you get a first line of defense for your family's overall health and well-being. From additional pediatric dental benefits for children, to in-network dentist savings to easy, online access to benefits, our Family Dental Plans have something for everyone. Contact your broker to learn more.

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Here's where to start:

Learn about the difference between HMO and PPO plans.

Learn about PPO plans.

PPO plans

Preferred provider organization

Care on your terms

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
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 *Los planes HMO no están disponibles en todas las áreas.

HMO plans

Health maintenance organization

Guided care with your doctor

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

Here's where to start:

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.

If you purchased your plan through Covered California, use t his handy guide to compare Blue Shield's Trio HMO (PDF, 667.9 KB) and PPO (PDF, 619.9 KB) plans.

 

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.

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

Ready to shop now

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.

Show all FAQs Show all FAQs

Do I qualify for financial help?

Learn about the new California Premium Subsidy and find out if you might qualify
 

Lower your premium

See how much you could save on your monthly premium.

Estimate savings

Learn more about health terms

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

Learn more about health terms

The terms and acronyms for health coverage can be confusing. Below 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.

 

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 & Dismemberment coverage. If you purchased your plan through Covered California, you also have the option of enrolling in a Family Dental Plan. Use this guide (PDF, 625KB) to learn more.

Enroll in dental and/or vision plan
 

Dental coverage

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

Dental coverage

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

Explore dental plans
 

Vision coverage

Vision plans starting at only $6.50 per month.

Vision coverage

Vision plans starting at only $6.50 per month.

Explore vision plans
 

Life coverage

Protect your loved ones’ financial security.

Life coverage

Protect your loved ones’ financial security.

Explore life insurance

Looking for dental, vision, and life insurance coverage?

 

Dental coverage

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

Explore dental plans
 

Vision coverage

Vision plans starting at only $6.50 per month.

Explore vision plans
 

Life coverage

Protect your loved ones’ financial security.

Explore life insurance

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.

Find HMO doctors Find PPO doctors

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.

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* Underwritten by Blue Shield of California Life & Health Insurance Company (Blue Shield Life).

† Covered California will contact you directly if you bought your plan through them, if there is anything you need to do to confirm your premium assistance (federal tax credits and/or state subsidy), or if there are any changes to your eligibility.

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