What’s new

What's new

Access+ HMO

Access infertility and fertility services to support your path to parenthood
Blue Shield plans will include coverage for the diagnosis and treatment of infertility and fertility services. This includes a lifetime maximum of three completed oocyte (egg) retrievals with unlimited embryo transfers. This coverage is the result of California Senate Bill 729, which expands access to fertility care. For details, see the "Infertility services" section of the Summary of Benefits – Medical – under Health plan documents.
Understand the new coverage requirements for GLP-1 and other weight loss drugs (for members who do not have an existing authorization from Blue Shield)
Weight loss drugs will be covered only for members who meet the following requirements:
• Have a body mass index (BMI) of 40 or higher (Class III obesity) before starting the drug
• Enroll in a comprehensive weight management program (such as one through Wellvolution®) for at least six months in the past year before using the drug
• Receive prior authorization from Blue Shield
• Continue the weight management program while taking the drug

Please note: If you are a member with an existing authorization from Blue Shield for a weight loss drug, you can continue taking the medication as long as you meet the criteria for reauthorization (i.e., the drug continues to be safe and effective, and you are still enrolled in a comprehensive weight management program).

Local Access+ HMO

Access infertility and fertility services to support your path to parenthood
Blue Shield plans will include coverage for the diagnosis and treatment of infertility and fertility services. This includes a lifetime maximum of three completed oocyte (egg) retrievals with unlimited embryo transfers. This coverage is the result of California Senate Bill 729, which expands access to fertility care. For details, see the "Infertility services" section of the Summary of Benefits – Medical – under Health plan documents.
Understand the new coverage requirements for GLP-1 and other weight loss drugs (for members who do not have an existing authorization from Blue Shield)
Weight loss drugs will be covered only for members who meet the following requirements:
• Have a body mass index (BMI) of 40 or higher (Class III obesity) before starting the drug
• Enroll in a comprehensive weight management program (such as one through Wellvolution®) for at least six months in the past year before using the drug
• Receive prior authorization from Blue Shield
• Continue the weight management program while taking the drug

Please note: If you are a member with an existing authorization from Blue Shield for a weight loss drug, you can continue taking the medication as long as you meet the criteria for reauthorization (i.e., the drug continues to be safe and effective, and you are still enrolled in a comprehensive weight management program).

Trio HMO

Access infertility and fertility services to support your path to parenthood
Blue Shield plans will include coverage for the diagnosis and treatment of infertility and fertility services. This includes a lifetime maximum of three completed oocyte (egg) retrievals with unlimited embryo transfers. This coverage is the result of California Senate Bill 729, which expands access to fertility care. For details, see the "Infertility services" section of the Summary of Benefits – Medical – under Health plan documents.
Understand the new coverage requirements for GLP-1 and other weight loss drugs (for members who do not have an existing authorization from Blue Shield)
Weight loss drugs will be covered only for members who meet the following requirements:
• Have a body mass index (BMI) of 40 or higher (Class III obesity) before starting the drug
• Enroll in a comprehensive weight management program (such as one through Wellvolution®) for at least six months in the past year before using the drug
• Receive prior authorization from Blue Shield
• Continue the weight management program while taking the drug

Please note: If you are a member with an existing authorization from Blue Shield for a weight loss drug, you can continue taking the medication as long as you meet the criteria for reauthorization (i.e., the drug continues to be safe and effective, and you are still enrolled in a comprehensive weight management program).

PPO

Access infertility and fertility services to support your path to parenthood
Blue Shield plans will include coverage for the diagnosis and treatment of infertility and fertility services. This includes a lifetime maximum of three completed oocyte (egg) retrievals with unlimited embryo transfers. This coverage is the result of California Senate Bill 729, which expands access to fertility care. For details, see the "Infertility services" section of the Summary of Benefits – Medical – under Health plan documents.
Understand the new coverage requirements for GLP-1 and other weight loss drugs (for members who do not have an existing authorization from Blue Shield)
Weight loss drugs will be covered only for members who meet the following requirements:
• Have a body mass index (BMI) of 40 or higher (Class III obesity) before starting the drug
• Enroll in a comprehensive weight management program (such as one through Wellvolution®) for at least six months in the past year before using the drug
• Receive prior authorization from Blue Shield
• Continue the weight management program while taking the drug

Please note: If you are a member with an existing authorization from Blue Shield for a weight loss drug, you can continue taking the medication as long as you meet the criteria for reauthorization (i.e., the drug continues to be safe and effective, and you are still enrolled in a comprehensive weight management program).

PPO with HSA

Access infertility and fertility services to support your path to parenthood
Blue Shield plans will include coverage for the diagnosis and treatment of infertility and fertility services. This includes a lifetime maximum of three completed oocyte (egg) retrievals with unlimited embryo transfers. This coverage is the result of California Senate Bill 729, which expands access to fertility care. For details, see the "Infertility services" section of the Summary of Benefits – Medical – under Health plan documents.
Understand the new coverage requirements for GLP-1 and other weight loss drugs (for members who do not have an existing authorization from Blue Shield)
Weight loss drugs will be covered only for members who meet the following requirements:
• Have a body mass index (BMI) of 40 or higher (Class III obesity) before starting the drug
• Enroll in a comprehensive weight management program (such as one through Wellvolution®) for at least six months in the past year before using the drug
• Receive prior authorization from Blue Shield
• Continue the weight management program while taking the drug

Please note: If you are a member with an existing authorization from Blue Shield for a weight loss drug, you can continue taking the medication as long as you meet the criteria for reauthorization (i.e., the drug continues to be safe and effective, and you are still enrolled in a comprehensive weight management program).