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Blue Shield Medicare (PPO) offers comprehensive medical and prescription drug coverage with the flexibility to access care from Medicare providers nationwide. This plan is ideal for members who like to self-refer to Medicare specialists.
Contact us
Customer Care
(888) 802-4599 (TTY 711)
7 a.m. - 8 p.m., seven days a week
Other plan features
  • Routine chiropractic and acupuncture services
  • Mental health benefits
  • Virtual care 24/7
Plan highlights
  • No deductible
  • $0 copayment for most covered services
  • $10 copayment for routine vision exam
  • Includes Part D pharmacy benefits
Blue Shield Medicare (PPO)
Offers comprehensive medical coverage. Includes Medicare prescriptions drug coverage (Part D).
Blue Shield Medicare (PPO) highlights:
Medicare prescriptions drug coverage (Part D) highlights:
  • Access to pharmacies across the United States: Albertsons, Costco, CVS Pharmacy, CVS Pharmacy at Target, Safeway, Vons, Walmart, and more!
  • Get 90-day refills for covered drugs for the cost of two 30-day copayments from select pharmacies.
  • $1,000 mail service out-of-pocket maximum. See the plan’s Evidence of Coverage for more details.

Plan features
Blue Shield Medicare (PPO) with Optional Supplemental vision & dental benefits
Offers comprehensive medical coverage. Includes Medicare prescription drug coverage (Part D).
Available to public agency and school employees only.
Blue Shield Medicare (PPO) highlights:
Medicare prescriptions drug coverage (Part D) highlights:
  • Access to pharmacies across the United States: Albertsons, Costco, CVS Pharmacy, CVS Pharmacy at Target, Safeway, Vons, Walmart, and more!
  • Get 90-day refills for covered drugs for the cost of two 30-day copayments from select pharmacies.
  • $1,000 mail service out-of-pocket maximum. See the plan’s Evidence of Coverage for more details.
Optional Supplemental vision & dental highlights:
  • Monthly $38 plan premium
  • Access to in-network and out-of-network providers
  • $0 copayment for oral exams & routine cleanings (once every 6 months)
  • $0 copayment for routine eye exam (once every 12 months)
  • $70 eyewear and $105 contact lens allowance (once every 24 months)

Plan features
You have the flexibility to see both in-network and out-of-network providers as long as they participate in Medicare and directly bill Blue Shield of California.


* These discount program services are not a covered benefit of your Blue Shield Medicare plan and none of the terms or conditions of the Blue Shield Medicare plan apply. The networks of practitioners and facilities in the discount programs are managed by external program administrators, including any screening and credentialing of providers. Blue Shield does not review the services provided by discount program providers for medical necessity or efficacy, nor does Blue Shield make any recommendations, representations, claims, or guarantees regarding the practitioners, their availability, fees, services, or products. Some services offered through the discount program may already be included as part of the Blue Shield Medicare covered benefits. Members should access those covered services prior to using the discount program. Members who are not satisfied with products or services received from the discount program may use the grievance process described in their Evidence of Coverage.

Blue Shield of California is a PPO plan with a Medicare contract. Enrollment in Blue Shield of California depends on contract renewal. Blue Shield of California offers individual and employer group retiree plans to Medicare beneficiaries who have Part A and Part B. Individual plans are open to all Medicare beneficiaries who reside within a plan’s specific service area. Employer group retiree plans are open only to Medicare beneficiaries who are eligible group retirees and who reside within a plan’s specific service area. Individual and employer group retiree plans have different service areas, benefits and provider networks.

Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Please call our Customer Care number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.

+You can place two orders per quarter and cannot roll over your unused allowance into the next quarter. Some limitations may apply. Refer to the OTC catalog for more information. Blue Shield of California’s pharmacy network includes access to pharmacies with preferred cost sharing in certain counties within California. The lower costs advertised in our plan materials for these pharmacies may not be available at the pharmacy you use. For up-to-date information about our network pharmacies, including preferred cost sharing, please call Customer care at (888) 802-4599 (TTY 711) 7 a.m. to 8 p.m., seven days a week or consult the online pharmacy directory at blueshieldca.com/calpers.

Wellvolution is a registered trademark of Blue Shield of California. Wellvolution and all associated digital and in-person health programs, services, and offerings are managed by Solera, Inc., a health company committed to changing lives by guiding people to better health in their communities.

NurseHelp 24/7 and LifeReferrals 24/7 are service marks of Blue Shield of California.

SilverSneakers is a registered trademark of Tivity Health, Inc. SilverSneakers LIVE, SilverSneakers On-Demand and SilverSneakers GO are trademarks of Tivity Health, Inc. © 2023 Tivity Health, Inc. All rights reserved
©2023 Teladoc, Inc. All rights reserved. Teladoc and the Teladoc logo are trademarks of Teladoc Health, Inc. and may not be used without written permission. Teladoc does not replace the primary care physician. Teladoc does not guarantee that a prescription will be written. Teladoc operates subject to state regulation and may not be available in certain states. Teladoc does not prescribe DEA-controlled substances, non-therapeutic drugs, and certain other drugs which may be harmful because of their potential for abuse. Teladoc physicians reserve the right to deny care for potential misuse of services. Your network providers may offer telehealth and in-office services. Contact your primary care provider, treating specialist, facility, or other health professional to learn whether telehealth is an option. Network telehealth and in-person services are subject to the same timely access to care standards. If your plan has out-of-network benefits they are subject to your plan’s cost sharing obligations and balance billing protections.

The company complies with applicable state laws and federal civil rights laws and does not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, ethnic group identification, medical condition, genetic information, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, mental disability, or physical disability. La compañía cumple con las leyes de derechos civiles federales y estatales aplicables, y no discrimina, ni excluye ni trata de manera diferente a las personas por su raza, color, país de origen, identificación con determinado grupo étnico, condición médica, información genética, ascendencia, religión, sexo, estado civil, género, identidad de género, orientación sexual, edad, ni discapacidad física ni mental. 本公司遵守適用的州法律和聯邦民權法律，並且不會以種族、膚色、原國籍、族群認同、醫療狀況、遺傳資訊、血統、宗教、性別、婚姻狀況、性別認同、性取向、年齡、精神殘疾或身體殘疾而進行歧視、排斥或區別對待他人。

Page Last Updated 8/4/22
H4937_22_407A_C 08092022