What’s new starting January 1, 2026
The EPO Plan (Exclusive Provider Organization)
New EPO Medical Plan
Effective January 1, 2026 you will have a new health plan from Blue Shield of California: the EPO plan. This will replace your current Access+ HMO health plan.
With the new EPO plan, you get the following:
• Access to a larger network of doctors, specialists, hospitals, and other providers in California through Blue Shield’s PPO network ‒ one of the largest networks in the state
• The freedom to self-refer to specialists – no need to see your primary care physician first
• Access to providers nationwide for covered services through the BlueCard ® Program
• No change to your copayments. These will remain the same as your current plan
To search for providers in the PPO network, use our Find a Doctor tool.
Important: With the new EPO plan, you must stay within the PPO network. You will not be covered for services from providers who are not in the PPO network - except for urgent and emergency care.
Compare costs for your prescription drugs
When your doctor gives you a new prescription, you can get alerts on your phone with pricing options. Download the Blue Shield of California app and enable push notifications to:
• Get alerts for new prescriptions
• Compare prices by pharmacy, brand name vs. generic, and more
• See all in-network pharmacy options
• Know your medication prices before you go to the pharmacy
Out-of-network or non-contracted providers are not required to treat plan members, unless it is an emergency. For more details – including cost-sharing information for out-of-network services – please contact our Customer Service team or refer to your Evidence of Coverage.