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View or download our convenient new member Trio HMO guide.  

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Receive up to a 90-day supply of covered maintenance drugs for chronic or long-term conditions delivered to your home or office, with no charge for shipping through CVS Caremark®. Get started now.

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Your New Trio HMO Plan

Welcome to Blue Shield.

Get started with the basics of your Trio Health Maintenance Organization (HMO) plan

Your primary care physician (PCP), who is your first point of contact for your health care, will treat your common illnesses and injuries and refer you to specialists.

  • A referral from your PCP is required to see any specialist.

  • Your covered family members can have their own PCPs.

  • You can change your PCP once per month.

The benefits of being a Trio HMO plan member are:

  • You have access to our Trio ACO HMO Network of doctors and hospitals, which includes more than 16,000 doctors in California.

  • There are many ways you can access care, including phone, online chat, and video options.

  • Your plan includes Shield Concierge, a team of healthcare experts and dedicated customer service representatives ready to answer all your benefits and health-related questions.

  • You are covered for urgent and emergency care when traveling throughout the country and abroad.

Steps to receiving care

 1. Get your ID card

We will send you your ID cards in the mail within 10 days after your initial payment has been applied and your enrollment is activated. Your ID card is proof of coverage when you go the doctor. You will receive an ID card for each covered member, which will include member name, member ID, group number, plan type, and PCP.

When you receive your ID cards, please review the information on your cards, including the PCP that we selected for you and the medical group. Call Shield Concierge at the number on the back of your card to request changes or report any errors. If you make any changes, you’ll receive a new ID card.

Make sure to keep your card handy so your information is easily accessible when you visit a doctor, hospital, or specialist.

If you signed up for your plan through Covered California and paid your initial premium but have not received your ID card within 10 business days, please call (855) 836-9705. If you signed up directly through Blue Shield, call (888) 256-3650.

 2. Create your online account

You will be able to register for an account as early as 30 days before your plan's effective date. For example, if your plan begins January 1, you can register starting December 1. Once you receive your ID card, use your member ID number to register for a blueshieldca.com account. Then log in to see your personal account.

With your online account, you can: 

  • View or print your ID card

  • Find a provider in your plan’s network with our Find a Doctor tool

  • View your billing, facility-related claims, and deductibles and copayments, updated daily

  • View or change your primary care physician

  • Chat with a nurse for health advice with NurseHelp 24/7SM

  • Get smart tips to control your healthcare costs and many other helpful resources

 3. Find a doctor

Our Find a Doctor tool lets you search for doctors, specialists and hospitals online anytime. Simply log in to find information about the doctors and hospitals that are in your plan's network.* A Trio HMO plan requires you to choose doctors who belong to a medical group that participates in the Trio ACO HMO Network.

* The search results will list providers that are participating in the plan you selected. 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.

Primary care physicians
Your primary care physician (PCP) is your first point of contact for your health care, who will treat your common illnesses and injuries, and refer you to specialists. Specialists focus on one area of medicine, such as dermatology, oncology or allergies. Each member covered by your plan may have his or her own PCP.

Primary care physicians are usually general practitioners and include:

  • Doctors of internal medicine, who care for people 18 and older

  • Family or general practice doctors, who care for people of all ages

  • Pediatricians, who care for people under 18

We’ve selected a PCP for you so you can get the care you need when you need it. View your PCP information in your online account at blueshieldca.com and find out more about PCP matching at blueshieldca.com/triopcp.

 4. Visit your doctor

When you’re ready to see a doctor, call the doctor’s office to make an appointment. Be sure to bring your Blue Shield ID card with you to your visit. If you’re planning to see a specialist, make sure you have a referral from your PCP.

Many preventive care services such as routine physical exams, screenings and vaccinations are covered 100% under your plan when you visit a doctor or your PCP in your plan’s network.   

For other services, you will pay a small fee, known as a copayment, to your doctor for each visit. In most cases, the copayment to see a specialist is different from a general office visit with a PCP. For more details, see your Evidence of Coverage and Health Services Agreement.

 5. Pay for care

You must see a doctor in your network. Your doctor or hospital will bill Blue Shield for most services, and we will then charge you the allowable amount.

Once you meet your deductible, Blue Shield will share most costs for covered services with you. This means you will pay a certain percentage of costs, or coinsurance, for covered services received from Blue Shield providers, and Blue Shield will pay the rest.

There is a limit to how much you have to spend out of your pocket each year before Blue Shield begins paying 100% for most covered medical services. This is called your plan’s out-of-pocket maximum.

Learn more about paying for health care.

To see an example of how your health plan works, click here.

For full details, please review your Evidence of Coverage and Health Services Agreement.

Receiving care from non-network providers
Services from non-network providers are only covered in the case of emergency treatment; or, if a specialist for the care you need is not in your plan's network, then you PCP will refer you to one outside the network.

Your PCP will refer you to specialists that are part of the same medical group. If you need a specialist who is not in that medical group or in the Trio ACO HMO Network, you may be referred out of network and still receive covered benefits.

For full details, please review your Evidence of Coverage and Health Services Agreement.

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