Welcome, CalPERS members
To help you make your health plan selection with confidence we have gathered Blue Shield EPO plan specific benefit information, tools, resources and much more for you.
Blue Shield EPO plan
Blue Shield EPO service area
The Blue Shield EPO plan is available in select rural counties.
To determine if you reside in the Blue Shield EPO service area, you can search you by zip code below.
- Current counties are Alpine, Calaveras, Colusa, Inyo, Lake, Lassen, Mendocino, Modoc, Mono, Plumas, Shasta, Sierra, Siskiyou, Tehama, Trinity and Tuolumne.
- New counties for 2024 Del Norte and San Benito.
To determine if you reside in the Blue Shield EPO service area, you can search you by zip code below.
What is the Blue Shield EPO plan?
The Blue Shield Exclusive Provider Organization (EPO) plan is designed solely for CalPERS members who live or work in rural areas where HMO plans are not as prevalent. By utilizing the Blue Shield PPO network members have the freedom and flexibility to access care in rural areas.
Blue Shield EPO plan highlights:
Blue Shield EPO plan highlights:
- Low, fixed copayments with no coinsurance or deductible.
- No need to see your primary care physician first - you can go to any specialist within the Blue Shield PPO network.
- New for 2024 The Away From Home Care program, which offers family members living outside of California - students, workers on long-distance assignments, etc. - access to medical care in select states across the country. (Availability varies by state).
- Blue Shield EPO plan documents
- Learn more about the Blue Shield EPO plan benefits
- Plan presentation
- Learn about Blue Shield EPO's 2024 health benefit offerings by watching the following plan option video presentation.
Watch our interactive video to help you:
Our interactive video will help you to:
- Compare plans quickly
- Find network doctors
- Explore wellness programs and more
How to access care
Pharmacy benefits
Blue Shield offers a self-managed pharmacy benefit program and does not utilize OptumRx. Members are prescribed medications by their doctors or specialists and have convenient access to an extensive pharmacy network, including Safeway/Vons, Costco, and CVS (including CVS Pharmacy® in Target stores).
- Learn more about Blue Shield EPO plan pharmacy benefits
- Blue Shield EPO pharmacy benefits and formularies
Costs per service as a Blue Shield EPO member
The benefit structure of the Blue Shield EPO plan is similar to the Access+ HMO plan with most services being covered by copayment.
For example:
For example:
- Most in-network services are covered at a $0 copayment.
- Lab work and imaging is covered at a $0 copayment (when visiting an in-network provider).
- Emergency room visits would be a $50 copayment.
- Learn more about what this plan covers & what you pay for covered services
- Blue Shield EPO plan summary of benefits and coverage
Find a Blue Shield EPO provider
Find more doctors, specialists, and services with Blue Shield's PPO network.
Programs and services
Teladoc
Talk to a board-certified Teladoc® doctor.
Blue Shield EPO members have access to speak with a doctor by phone for a $0 copayment.
Mental health resources
Blue Shield contracts with Mental Health Services Administrator (MHSA) to provide access to over 15,000 behavioral health clinicians and facilities. You can find mental health providers, including in-patient and out-patient care, through Magellan Health Services.
Steps to search online through Magellan Health Services:
Steps to search online through Magellan Health Services:
- Click the "Find a provider" button below and you will be redirected to Magellan’s website
- Select “BSC MHSA” as your benefit plan
- Choose “Non-Medicare Provider or Facility”
- Type in your zip code
- Select “Accepting new patients”
Our mental health resource hub, powered by CredibleMind
Available at no extra cost
CredibleMind offers many different resources, all in one place. You can navigate by topic, including everything from stress and anxiety to happiness and resilience.