Blue Shield plan transition for Coordinated Choice Plan members | Blue Shield Medicare
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Coordinated Choice plan change

happy couple Coordinated Choice Plan change

Blue Shield plan transition for Coordinated Choice Plan members

Blue Shield Coordinated Choice Plan (HMO) members will soon transition to a Blue Shield HMO D-SNP or HMO plan. This may seem like a big change. But the good news is that your new plan will have compatible coverage through Blue Shield of California. So you can expect many similar features as your current Blue Shield Coordinated Choice Plan (HMO).

View the Frequently Asked Questions below to learn more about this transition. You can also call Customer Care at (800) 776-4466 (TTY: 711), 8 a.m. to 8 p.m., seven days a week.

View the Annual Notice of Change (ANOC) for your new plan

To view information about all our current Medicare plans, visit our Medicare site.


Frequently asked questions


  • What is happening to Blue Shield of California Coordinated Choice Plan (HMO) (“Coordinated Choice”)?

    The Centers for Medicare & Medicaid Services (CMS) is requiring all Dual Eligible Special Needs Plan (D-SNP) Look-Alikes with 80% or more duals enrolled to close. Blue Shield Coordinated Choice Plan is a HMO D-SNP Look-Alike with more than 90% duals enrolled, so we are required to end the plan effective December 31, 2022. As a result, we will be transitioning all Coordinated Choice members to another Blue Shield plan effective January 1, 2023.

  • What is a D-SNP Look-Alike plan?

    A D-SNP Look-Alike plan is an Individual Medicare Advantage HMO plan designed to look like a D-SNP. Your current Blue Shield Coordinated Choice Plan is a D-SNP Look-Alike plan. Unlike D-SNP plans, Look-Alike plans are not subject to the same requirements set forth by state and federal regulators to coordinate a member’s Medicare and Medi-Cal benefits. As a result, full dual members in Look-Alike plans do not have the same care coordination support or member experience that they would in a true D-SNP. Partial dual and non-dual members in these plans may also pay higher coinsurance and deductibles than they would in other Medicare Advantage HMO plans.

  • What is the difference between a Dual Eligible Special Needs plan and Dual Look-Alike plan?
      D-SNP Plan D-SNP "Look-Alike" Plan
    Who is eligible for enrollment? Full Dual Full Dual
    Partial Dual
    Health plan must have State Medicaid Agency Contract (SMAC) with California Department of Health Care Services  
    Health plan must have a Model of Care approved by the Centers for Medicare & Medicaid Services  
  • What will happen to my health plan when Blue Shield Coordinated Choice Plan closes?

    You will be automatically transitioned into a compatible Blue Shield HMO D-SNP or Blue Shield Medicare Advantage HMO plan. Minus a few exceptions, most full dual beneficiaries will move to one of our Blue Shield HMO D-SNP plans, while partial dual and non-dual beneficiaries will move to a Blue Shield Medicare Advantage HMO plan available in your county that offers lower copayments while maintaining rich benefits.

  • Will I continue to receive health services?

    You will receive services through Blue Shield Coordinated Choice Plan (HMO) until December 31, 2022. Then on January 1, 2023, you will receive services through your new Blue Shield plan without a gap in coverage between the two plans. You do not need to do anything. Blue Shield will work with CMS to transition you from your current plan to your new plan.

  • What do I have to do during the transition?

    Nothing if you would like to stay with Blue Shield and move into the plan we’ve selected for you.

  • Can I choose to enroll into a different plan instead of the plan chosen for me?

    Yes, you can opt out of the plan we’ve selected for you and enroll into any of Blue Shield’s Medicare Advantage plan, Medicare Supplement plan, or Prescription Drug Plan offerings. However, if a HMO D-SNP is offered in your county and you are fully dual eligible, the HMO D-SNP is the best option available for you. If you would like to explore other Blue Shield plans, you can call our Blue Shield Direct Sales team at (800) 488-8000 (TTY: 711) seven days a week 8am-8pm from October 1 through March 31 and 8am-8pm weekdays (8am-5pm Saturdays and Sundays) from April 1 through September 30.

    We recommend staying with Blue Shield to avoid disruption and member service issues. But if you want to explore your plan options with other carriers, you can call 1-800-Medicare (TTY: (877) 486-2048) or speak with a health insurance counselor at the California Health Insurance Counseling & Advocacy Program (HICAP) at (800) 434-0222 (TTY: 711).

  • What will happen to any benefits, items, or services I am receiving before the transition?

    Blue Shield will copy all your active authorizations under your current plan to your new plan to ensure continuity and access to care remains intact throughout the transition.

  • Will I be formally notified that my plan is ending?

    Blue Shield will send letters informing you of the transition at least 90 days prior to your plan ending on December 31, 2022.

  • Is there a phone number I can call if I need help?

    Yes, you can call your current plan’s Customer Care phone number located on your Blue Shield member ID card.

  • Will I have the option to continue seeing my current doctor?

    The Blue Shield Medicare Advantage HMO or HMO D-SNP plan members transition into will include most of the same providers as Blue Shield Coordinated Choice Plan. In the unlikely event that you are unable to keep your provider, you will be notified 60 days prior to the transition, and Blue Shield will help you find a network provider that meets your needs.

  • Will I receive a new member ID card?

    Yes, you will receive your new member ID card prior to the January 1, 2023, effective date and there will be no gap in coverage. You will also be able to keep your existing Subscriber ID as you move to your new Blue Shield Medicare plan.

  • Can I keep my broker?


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Page last updated: 10/1/2022

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