Low-cost access to primary care

The Blue Shield Bronze 60 Trio HMO plan offers access to primary care at a lower premium compared to other Blue Shield HMO plans in exchange for higher cost-sharing for major healthcare services (like surgeries). You also have the option to open a health savings account (HSA) to pay for qualified healthcare expenses throughout the year.

Members pay a flat copay for office visits, diagnostic labs, and urgent care center services, and a coinsurance of 40% for most other covered services after meeting the deductible. Blue Shield pays approximately 60% of the allowable amount with this plan.

You can buy this plan direct from Blue Shield or from the Covered California marketplace.

Our IFP Trio HMO network

The IFP Trio HMO network connects you with more than 9,000 primary care doctors and 33,000 specialists who can help manage your care in person or virtually. Find network doctors, medical groups, and hospitals near you.

More ways to see your doctor, same copay

You’ll pay the same copay for a primary care visit whether it’s in person or virtual.

Teladoc virtual visits for $0

Get quick care from a doctor or mental health professional at Teladoc Health. Appointments are by phone or video at no added cost.

Coverage that travels with you

You’re covered for urgent and emergency care anywhere in the world.

In-person vs. virtual care

Some doctors offer both in-person and virtual visits. You can even choose a virtual-only doctor to be your primary care physician.

A primary care doctor is one you see regularly for ongoing care.* For urgent needs, you can choose to speak with a virtual doctor at Teladoc Health for $0.

Learn about HSAs
This plan is designed to be a health savings account (HSA) eligible plan. Once you enroll in an HSA, you can use it as a personal savings account to pay for qualified medical, dental, and vision expenses.
How an HSA helps you save†

HSAs offer potential tax advantages. Contributions are generally made on a pre-tax or tax-deductible basis. Earnings may grow tax-free, and you may use the funds tax-free when paying for IRS-qualified medical expenses.

Keep what you don’t spend

Unused funds in your HSA roll over year after year if you don't spend them. All the money in your HSA is owned by you.

How these plans work
Healthcare in an HMO network 
What you’ll pay
Learn about health plan costs

Benefit amounts reflect member costs when receiving care from in-network providers.

 Blue Shield Bronze 60 Trio HMO
Deductibles and maximum out-of-pocket
Calendar year medical deductible$5,800 per individual / $11,600 per family1
Calendar year pharmacy deductible$450 per individual / $900 per family1
Calendar year out-of-pocket maximum2$11,650 per individual / $23,300 per family
Care from your providers (physician services)
Primary Care  Preventive care
$0
Office visit
(in-person or telehealth)		$60
Specialist Office visit
(in-person or telehealth)		$100 for first 3 visits per calendar year prior to deductible, then $100 after deductible3
Mental health / substance use disorders Office visit
(in-person or telehealth)		$60
Labs and tests (diagnostic X-ray, imaging, pathology, and laboratory services)
Laboratory and pathology services at a laboratory center$50
Basic imaging services (including X-rays and ultrasounds) at an outpatient radiology center40%
(subject to deductible)
Emergency and urgent care services
Emergency room Physician services$0
Facility services (waived if admitted to the hospital)40%
(subject to deductible)
Urgent care center services (in-person or telehealth)$60 per visit
Care at the hospital (inpatient and outpatient services in a hospital setting)
Inpatient Physician services40%
(subject to deductible)
Facility services
40%
(subject to deductible)
Outpatient Physician services40%
(subject to deductible)
Facility services40%
(subject to deductible)
Dental and vision care for kids (pediatric dental and vision for children up to age 19)
Dental Oral exam$0
Preventive cleaning$0
Topical fluoride$0
Vision Comprehensive eye exam$0
Glasses (collection frames)4$0
Contacts (hard or soft, elective or non-elective)$0
Prescription drugs from your local network pharmacy or Amazon Pharmacy home delivery
Contraceptive drugs and devices 30 day supply$0
90 day supply home delivery$0
Tier 1 30 day supply$20 per prescription
90 day supply home delivery$60 per prescription
Tier 2 30 day supply40%
(up to $500 per prescription and subject to pharmacy deductible)
90 day supply home delivery40%
(up to $1,500 per prescription and subject to pharmacy deductible)
Tier 3 30 day supply40%
(up to $500 per prescription and subject to pharmacy deductible)
90 day supply home delivery40%
(up to $1,500 per prescription and subject to pharmacy deductible)
Tier 4 30 day supply40%
(up to $500 per prescription and subject to pharmacy deductible)
90 day supply home delivery40%
(up to $1,500 per prescription and subject to pharmacy deductible)
Additional features
Health savings account (HSA) eligible Consult with your financial or tax advisor if you have questions about HSAs.Yes
Out of state care coverage BlueCard® service areaLimited coverage - refer to the Evidence of Coverage
Other professional services Teladoc Health consultation$0
Chiropractic servicesNot Covered

1. Family coverage has an individual deductible within the family deductible. Blue Shield will pay benefits for an individual member on the family plan once the member meets the individual deductible amount. Blue Shield will pay benefits for all covered family members once the family deductible is satisfied. The family deductible can be satisfied when two family members meet their individual deductibles, or when the combined deductible contributions of three or more members reaches the family deductible limit.

2. Family coverage includes an individual out of pocket maximum (OOPM) within the overall family OOPM. Blue Shield pays 100% for covered services for a family member once that person meets their individual OOPM. Blue Shield pays 100% for all covered family members once the family OOPM is met. The family OOPM can be reached when two members meet their individual OOPM or when the combined OOPM amounts of three or more members reach the family limit.

3. The first three visits are available for a $100 copay prior to meeting the calendar-year medical deductible. Members will pay the full contracted rate for subsequent visits until their calendar-year medical deductible has been satisfied. Then, once again, members will pay a $100 copay for specialist office visits.

4. Collection frames are pre-selected frames by insurance providers which are fully covered with no out of pocket costs. Non-collection frames are other standard retail or designer frames with a fixed allowance.

* A referral from your PCP is required to see virtual and in-person providers and specialists.

† Blue Shield does not offer HSAs or tax advice. HSAs are offered through unaffiliated financial institutions. Tax treatment and eligibility are subject to IRS rules and individual circumstances. Residents of California pay full state income tax on HSA contributions, growth and distributions. Consult IRS Publication 969 or your tax advisor for guidance.

This page provides details on plan deductibles, copayments, and coinsurance amounts for common services when using in-network providers. It is not a contract. Plan benefits are only available when using providers in the IFP Trio HMO network. Services received from providers outside of your network and medical group are not covered, except for emergency, urgent, and follow-up care. For complete plan details, refer to the Evidence of Coverage (EOC) available under Individual and Family plan documents, or call us at (888) 256-3650.