Skip to main content
CalPERS home
Plan overview
Blue Shield Non-Medicare Plans
Blue Shield offers three health plans to CalPERS members: Access+ HMO, Trio HMO and the Blue Shield EPO plans.
Reasons to choose the Trio HMO plan for 2023:
In addition to the same features as the Access+ HMO plan, you get:
  • Lower cost
  • Access to virtual care for $0 copayments
  • Discounts on fruits, vegetables and other eligible healthy foods
Learn about your plan options
Our self-guided videos can help you find the plan that's best for you.
Access+ HMO Plan
Same broad network with lower rates for 2023.
  • Lowest cost broad-network HMO plan available to CalPERS members
  • No deductible
  • $0 copayments for 24/7 virtual care and many covered services
  • Self-refer to specialists*
  • An extensive pharmacy network, including Safeway/Vons, Costco, and CVS.

Plan features

2023 Medical benefits at-a-glance

BenefitsYou pay
Calendar-year deductible
Member/familyNone
Physician services
Preventive health examNo Charge
Pregnancy and maternity care: prenatal/postnatal office visitsNo Charge
Well-baby careNo Charge
Immunization/inoculationNo Charge
Allergy testing/treatmentNo Charge
Primary care office visits$15/visit
Teladoc medical doctor or phone consultation$0/call
Urgent care$15/visit
Infertility testing and treatment50% of allowable amount
Physician inpatient hospital visitsNo Charge
Surgery/anesthesiaNo Charge
Chiropractic and acupuncture services
Combined maximum of 20 visits per year$15/visit
Access+ Specialist
Access+ Specialists care office visit (self-referral)*$30/visit
Other specialist care office visit (referred by PCP)$15/visit
Hospital services
InpatientNo Charge
OutpatientNo Charge
Ambulatory surgery centersNo Charge
Transgender surgical centersNo Charge
Ambulance servicesNo Charge
Emergency care - no copayment if hospitalized or kept for observation$50/visit
Diagnostic X-ray/lab
InpatientNo Charge
Skilled nursing facility
InpatientNo Charge
Hospice
HospiceNo Charge
Mental health/substance use disorder
InpatientNo Charge
Outpatient$15/visit
Office visits$15/visit
Flu vaccine
From participating retail pharmaciesNo Charge
Vision care
Eye refraction to determine need for corrective lensesNo Charge
Eyeglasses - not covered, except for those that are necessary after cataract surgery20% discount available
Hearing aid services
EvaluationNo Charge
Hearing aid - up to a maximum of $1,000 per member, every 36 months for both ears for the hearing aid instrument and ancillary equipmentCharges in excess of $1,000
Durable medical equipment
Including orthoses and prosthesesNo Charge
Physical/occupational/speech therapy
Inpatient visits at a hospital or skilled nursing facilityNo Charge
Outpatient and home visits$15/visit
Medical benefit calendar-year out-of-pocket maximum
Member: $1,500Family: $3,000
Please see your Evidence of Coverage and Disclosure (EOC&D) for a detailed description of coverage benefits and limitations.
Trio HMO Plan
To enroll, you must have a primary residence or workplace within the Trio service area.

Available in these counties for 2023:

•Butte (new) • El Dorado • Kern (new) • Kings (new) • Los Angeles • Monterey (new) • Nevada • Orange • Placer •Riverside (new) • Sacramento •San Bernardino (new) • San Luis Obispo • Santa Barbara • Santa Cruz • Stanislaus •Tulare (new) • Ventura • Yolo
  • Same benefits and lower contribution rates than Access+ HMO
  • No deductible
  • $0 copayments for 24/7 virtual care and many covered services
  • Self-refer to specialists**
  • An extensive pharmacy network, including Safeway/Vons, Costco, and CVS.

Plan features

2023 Medical benefits at-a-glance

BenefitsYou pay
Calendar-year deductible
Member/familyNone
Physician services
Preventive health examNo Charge
Pregnancy and maternity care: prenatal/postnatal office visitsNo Charge
Well-baby careNo Charge
Immunization/inoculationNo Charge
Allergy testing/treatmentNo Charge
Primary care office visits$15/visit
Teladoc medical doctor or mental health professional video or phone consultation$0/call
Urgent care$15/visit
Infertility testing and treatment50% of allowable amount
Physician inpatient hospital visitsNo Charge
Surgery/anesthesiaNo Charge
Chiropractic and acupuncture services
Combined maximum of 20 visits per year$15/visit
Trio+ Specialist
Trio+ Specialists care office visit (self-referral)**$30/visit
Other specialist care office visit (referred by PCP)$15/visit
Hospital services
InpatientNo Charge
OutpatientNo Charge
Ambulatory surgery centersNo Charge
Transgender surgical centersNo Charge
Ambulance servicesNo Charge
Emergency care - no copayment if hospitalized or kept for observation$50/visit
Diagnostic X-ray/lab
InpatientNo Charge
Skilled nursing facility
InpatientNo Charge
Hospice
HospiceNo Charge
Mental health/substance use disorder
InpatientNo Charge
Outpatient$15/visit
Office visits$15/visit
Flu vaccine
From participating retail pharmaciesNo Charge
Vision care
Eye refraction to determine need for corrective lensesNo Charge
Eyeglasses - not covered, except for those that are necessary after cataract surgery20% discount available
Hearing aid services
EvaluationNo Charge
Hearing aid - up to a maximum of $1,000 per member, every 36 months for both ears for the hearing aid instrument and ancillary equipmentCharges in excess of $1,000
Durable medical equipment
Including orthoses and prosthesesNo Charge
Physical/occupational/speech therapy
Inpatient visits at a hospital or skilled nursing facilityNo Charge
Outpatient and home visits$15/visit
Medical benefit calendar-year out-of-pocket maximum
Member: $1,500Family: $3,000
Please see your Evidence of Coverage and Disclosure (EOC&D) for a detailed description of coverage benefits and limitations.
Blue Shield EPO Plan
Available in these counties for 2023:

•Alpine (new) • Calaveras (new) •Colusa • Inyo (new) •Lake (new) • Lassen (new) • Mendocino •Modoc (new) • Mono (new) •Plumas (new) •Shasta • Sierra •Siskiyou (new) •Tehama (new) •Trinity (new) •Tuolumne (new)
  • Access to providers in the broad Blue Shield Preferred Provider network
  • Same benefits as those in the Access+ HMO plan
  • Self-referral to specialists without a referral from a primary care physician
  • $0 copayments for 24/7 virtual care and many covered services
  • An extensive pharmacy network, including Safeway, Costco, and CVS.

Plan features

2023 Medical benefits at-a-glance

BenefitsYou pay
Calendar-year deductible
Member/familyNone
Physician services
Preventive health examNo Charge
Gynecological/well-woman examNo Charge
Pregnancy and maternity care: prenatal/postnatal office visitsNo Charge
Well-baby careNo Charge
Immunization/inoculationNo Charge
Allergy testing/treatmentNo Charge
Primary care office visits$15/visit
Teladoc medical doctor or phone consultation$0/call
Urgent care$15/visit
Infertility testing and treatment50% of allowable amount
Physician inpatient hospital visitsNo Charge
Surgery/anesthesiaNo Charge
Chiropractic and acupuncture services
Combined maximum of 20 visits per year$15/visit
Specialist
Specialist care office visit$15/visit
Hospital services
InpatientNo Charge
OutpatientNo Charge
Ambulatory surgery centersNo Charge
Transgender surgical centersNo Charge
Ambulance servicesNo Charge
Emergency care - no copayment if hospitalized or kept for observation$50/visit
Diagnostic X-ray/lab
InpatientNo Charge
Skilled nursing facility
InpatientNo Charge
Hospice
HospiceNo Charge
Mental health/substance use disorder
InpatientNo Charge
Outpatient$15/visit
Office visits$15/visit
Flu vaccine
From participating retail pharmaciesNo Charge
Vision care
Eye refraction to determine need for corrective lensesNo Charge
Eyeglasses - not covered, except for those that are necessary after cataract surgery20% discount available
Hearing aid services
EvaluationNo Charge
Hearing aid - up to a maximum of $1,000 per member, every 36 months for both ears for the hearing aid instrument and ancillary equipmentCharges in excess of $1,000
Durable medical equipment
Including orthoses and prosthesesNo Charge
Physical/occupational/speech therapy
Inpatient visits at a hospital or skilled nursing facilityNo Charge
Outpatient and home visits$15/visit
Medical benefit calendar-year out-of-pocket maximum
Member: $1,500Family: $3,000
Please see your Evidence of Coverage and Disclosure (EOC&D) for a detailed description of coverage benefits and limitations.
* To use this option, members must select a PCP who is affiliated with a medical group or IPA that is an Access+ provider group, which offers the Access+ Specialist feature. Members should then select a specialist within that medical group or IPA. This benefit is for a first specialist visit only; subsequent visits will require a referral. Access+ Specialist visits for mental health services must be provided by a participating mental health service administrator (MHSA) network provider. Access+ HMO is a registered trademark of Blue Shield of California.

** To use this option, members must select a PCP who is affiliated with a medical group or IPA that is a Trio+ provider group, which offers the Trio+ Specialist feature. Members should then select a specialist within that medical group or IPA. This benefit is for a first specialist visit only; subsequent visits will require a referral. Trio+ Specialist visits for mental health services must be provided by a participating mental health service administrator (MHSA) network provider.