Health plan documents for CalPERS retirees
Blue Shield Group Medicare Advantage (PPO) plan
Blue Shield Group Medicare Advantage (PPO) plan: January 1, 2027 - December 31, 2027
- Summary of Benefits
- Evidence of Coverage
- Provider Directory (coming soon)
- Travel Reimbursement Form
Blue Shield Group Medicare Advantage (PPO) plan with Dental and Vision plan
Blue Shield Group Medicare Advantage (PPO) plan with Dental and Vision plan: January 1, 2027 - December 31, 2027
- Summary of Benefits
- Evidence of Coverage
- Provider Directory (coming soon)
- Travel Reimbursement Form
Blue Shield of California Medicare Rx Plan (PDP)
Blue Shield of California Medicare Rx plan (PDP): January 1, 2027 - December 31, 2027
- Summary of Benefits
- Evidence of Coverage
- Formulary Drug List (coming soon)
- Pharmacy Directory (coming soon)
- Provider Directory (coming soon)
Blue Shield of California is a PPO and PDP plan with a Medicare contract. Enrollment in Blue Shield of California depends on contract renewal.
Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Please call our Customer Service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.
Y0118_26_160A_M 07292026
Page Last Updated 07/31/2026