Welcome
PRISM
participants
Contact us
Blue Shield Member Services
Representatives provide answers to questions regarding claims, general plan information, coverage, and authorization determinations.
(855) 599-2650
7 a.m. to 7 p.m. Pacific Time
Monday – Friday
BlueCard Program
Provides you and your eligible family access to covered services, including urgent and emergency care, while you are traveling or working outside of California.
(800) 810-BLUE (2583)
24-hours a day, 7 days a week
Representatives provide answers to questions regarding claims, general plan information, coverage, and authorization determinations.
(855) 599-2650
7 a.m. to 7 p.m. Pacific Time
Monday – Friday
BlueCard Program
Provides you and your eligible family access to covered services, including urgent and emergency care, while you are traveling or working outside of California.
(800) 810-BLUE (2583)
24-hours a day, 7 days a week
Have you scheduled your preventive care visit?
Take charge of your health today
Preventive care is key to finding possible health issues early. Learn about the preventive care services covered under your plan. Find out which health screenings and immunizations are right for you and your family.
When your health care becomes complicated, you don’t have to go it alone
With Care Management from Shield Support, you’ve got a team of nurses, health coaches, and other specialists by your side – at no additional cost to you.
Your plan offerings
Access+ HMO plan
With the Access+ HMO® plan, you will:
When you enroll in the Access+ HMO plan for the first time, you must choose a PCP for yourself and your covered dependents. Each member of your family can choose a different physician and medical group/IPA.
- Only pay a fixed copayment for most services like doctor visits, urgent care, and emergency care.
- Have access to one of the largest provider networks in California with more than 10,000 primary care physicians (PCPs), 270 hospitals, and 34,000 specialists.
- Choose a PCP who will coordinate your care and refer you to specialists and hospitals within their medical group/Independent Practice Association (IPA).
When you enroll in the Access+ HMO plan for the first time, you must choose a PCP for yourself and your covered dependents. Each member of your family can choose a different physician and medical group/IPA.
Trio HMO plan
The Trio HMO plan:
When you enroll in the Trio HMO plan for the first time, you must choose a PCP for yourself and your covered dependents. Each member of your family can choose a different physician and medical group/IPA.
- Has no deductible, just fixed copays.
- Is typically more affordable than other plans.
- Features a select network of local providers who closely coordinate your care.
- Offers a concierge service to help you with everything from benefit questions to scheduling doctor’s appointments.
When you enroll in the Trio HMO plan for the first time, you must choose a PCP for yourself and your covered dependents. Each member of your family can choose a different physician and medical group/IPA.
BlueHPN plan
With the BlueHPN plan, you can:
- Access care within the BlueHPN service areas only.
- Self-refer to specialists within the BlueHPN network.
- Usually get low, fixed copayments, just like an HMO plan.
EPO plan
With the EPO plan, you will:
- Have nationwide access to PPO network providers.
- Usually get low, fixed copayments, just like an HMO plan.
- Not be covered for services from providers who are not in the PPO network, except for emergencies.
High Deductible Health Plan (HDHP)
With the HDHP, you can:
- See any doctor you choose for most services.
- Self-refer to specialists.
- Usually pay less for services that are provided by PPO network providers.
PPO plan
The PPO plan allows you to:
- See any doctor you choose for most services.
- Self-refer to specialists.
- Usually pay less for services that are provided by PPO network providers.
- Pay a copayment or coinsurance for most services after the plan’s deductible has been met.
Tandem PPO plan
Our Tandem PPO plan:
- Offers the flexibility of a PPO plan but is typically more affordable due to a select network of providers.
- Includes over 65% of doctors and 90% of hospitals from our broad PPO network.
- Offers concierge support services to help answer your questions about benefits, claims, and more.
Find a provider
Our virtual assistant is available to help you find a provider
Do you need your primary care physician's (PCP's) ID number? Once you find your PCP, select the More info button.
- Advanced provider searchSearch for providers in California by multiple criteria such as gender, language, etc. Select your plan's Find a Doctor link below to begin your search. To find your PCP’s ID number, click on the doctor’s name and select View details under "Primary Care Physician ID."
- Access+ HMO Find a Doctor
- Trio HMO Find a Doctor
- BlueHPN Find a DoctorWhen searching outside of CA use prefix - TEF
- EPO Find a Doctor
- PPO Find a Doctor
- Tandem PPO Find a Doctor
- Find a Doctor TutorialsWatch our tutorials on how to use the Find a Doctor tool.
Pharmacy benefits
Access+ HMO, BlueHPN, PPO, and EPO plan members
Your prescriptions are administered through Express Scripts. To access information about your prescription drug coverage, visit Express Scripts.
HDHP plan members
Prescription drug benefits are an important part of your Blue Shield health plan.
Understanding your pharmacy benefits can help you save money. You may save if your medication is a preferred prescription drug. Also, if you take a stabilized doses of covered medications for chronic conditions such as diabetes, you can have a 90-day supply delivered through our mail service pharmacy. Shipping is free, and you may save on your copay.
Understanding your pharmacy benefits can help you save money. You may save if your medication is a preferred prescription drug. Also, if you take a stabilized doses of covered medications for chronic conditions such as diabetes, you can have a 90-day supply delivered through our mail service pharmacy. Shipping is free, and you may save on your copay.
- Pharmacy benefits for HDHP plan
- Mail service prescriptions
- Frequently asked questions
- Plus drug formulary
- Locate pharmacies
Programs and services in the spotlight
Save a trip to the doctor’s office
Talk to a board-certified Teladoc® medical doctor or mental health professional by phone or video.
Maternity care that fits into your life
The Maven Maternity Program is designed to give you and your partner digital and virtual support for your pregnancy and postpartum needs – at no extra cost. You can also get support if you have experienced a pregnancy loss.
Decrease your stress
Fitness Your WayTM offers access to virtual classes, gyms with no long-term contracts, and more.
All programs and services
- AccoladeGet help navigating your health and benefits.
- Away From Home Care® Program – available only to HMO members and their dependentsStay covered when you're away from home for extended periods.
- Care Management Program (Shield Support)Get support managing conditions such as diabetes and depression.
- Fitness Your Way™Access network fitness centers on a budget you can live with.
- Identity theft protectionProtecting your financial well-being is as important as protecting your health.
- LifeReferrals 24/7SM *Experienced professionals are ready to help you with personal, family, and work issues at any time.
- Maternity ProgramGet support before, during, and after your pregnancy
- MinuteClinic® – available only to PPO plan membersGet virtual or walk-in non-emergency health care at CVS MinuteClinics across California.
- Network retail pharmacy vaccine programGet vaccines for the flu, shingles, and more at a network retail pharmacy.
- NurseHelp 24/7SM *Registered nurses are available to answer your health questions at any time, every day.
- Preventive careLearn how your preventive care benefits can help keep you healthy.
- Shield ConciergeGet answers to your questions about your health plan benefits and much more.
- Teladoc® virtual medical and mental health servicesTalk to a board-certified Teladoc medical doctor or licensed mental health professional by phone or video for a $0 copay.
- Wellness discount programs *Get help living healthier with a wide range of discount programs.
* These discount program services are not a covered benefit of your Blue Shield of California, Blue Shield of California Life & Health Insurance Company (Blue Shield Life), or self-insured health plan, and none of the terms or conditions of the Blue Shield, Blue Shield Life, or self-insured health 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 plan covered benefits. Members or self-insured plan participants should access those covered services prior to using the discount program. Members or self-insured plan participants who are not satisfied with products or services received from the discount program may use the grievance process described in their Evidence of Coverage, Disclosure Form, Evidence of Coverage and Disclosure Form, Benefit Booklet or Certificate of Insurance/ Policy. Blue Shield reserves the right to terminate this program at any time without notice.
NurseHelp 24/7 and LifeReferrals 24/7 are service marks of Blue Shield of California.
NurseHelp 24/7 and LifeReferrals 24/7 are service marks of Blue Shield of California.