What’s the difference between an HMO and a PPO plan (if both are offered)?

With an HMO plan, you will need to select a primary care physician (PCP) who will coordinate your care and refer you to specialists, if needed. You will also typically have lower out-of-pocket costs.

A PPO plan offers the most choice and flexibility. With a PPO plan, you can see providers in our broad PPO network, within California and nationwide.

Are there specific doctors, specialists, or hospitals that you want to access?

If yes, you can see if your providers are in Blue Shield’s network for the plans being offered by using our Find a Doctor tool. A PPO plan (if offered) will give you the most choice and flexibility, allowing you to see both in-network and out-of-network providers. Please note: You may pay more to see out-of-network providers than you would to see in-network providers.

Do you or your family members have a chronic condition, or will you require any medical procedures in the next year?

If yes, use our Find a Doctor tool to make sure your preferred specialists and hospitals are in a plan’s network. Please note: With an HMO plan you will typically have lower out-of-pocket costs than with a PPO plan.

Do you travel out of state or out of the country?

If yes, keep in mind that all Blue Shield plans offer coverage for urgent and emergency care anywhere in the world.