Access+ HMO plan

Starting January 1, 2026

• Explore the upcoming behavioral health transition
  You’ll have access to an expanded, quality network. Learn more.
• Access expanded infertility and fertility services to support your path to parenthood
  Blue Shield plans will include expanded 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 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).

Available as of July 1, 2025

• Compare prices for your new 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 mobile 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

Trio HMO plan

Starting January 1, 2026

• Explore the upcoming behavioral health transition
  You’ll have access to an expanded, quality network. Learn more.
• Access expanded infertility and fertility services to support your path to parenthood
  Blue Shield plans will include expanded 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 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).

Available as of July 1, 2025

• Compare prices for your new 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 mobile 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

PPO plan

Starting January 1, 2026

• Explore the upcoming behavioral health transition
  You’ll have access to an expanded, quality network. Learn more.
• Access expanded infertility and fertility services to support your path to parenthood
  Blue Shield plans will include expanded 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 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).

Available as of July 1, 2025

• Compare prices for your new 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 mobile 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

PPO out-of-area plan

Starting January 1, 2026

• Explore the upcoming behavioral health transition
  You’ll have access to an expanded, quality network. Learn more.
• Access expanded infertility and fertility services to support your path to parenthood
  Blue Shield plans will include expanded 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 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).

Available as of July 1, 2025

• Compare prices for your new 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 mobile 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

PPO 20 plan

Starting January 1, 2026

• Explore the upcoming behavioral health transition
  You’ll have access to an expanded, quality network. Learn more.
• Access expanded infertility and fertility services to support your path to parenthood
  Blue Shield plans will include expanded 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 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).

Available as of July 1, 2025

• Compare prices for your new 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 mobile 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