Learn about the Shield Signature plan

Plan overview:

As a Shield Signature plan member, you have access to covered services from HMO and PPO network providers:

HMO (Level 1): You can get care from HMO network providers for Level 1 benefits that have fixed copayments and the lowest out-of-pocket costs.
PPO (Level 2): You can access care from PPO network providers for Level 2 benefits that allow you to self-refer to doctors for select outpatient services. Typically, your out-of-pocket cost will be higher than the costs for seeing HMO network providers.

Care from HMO (Level 1) providers

All family members must select a primary care physician (PCP) when enrolling in the plan. You have the option to choose a different PCP and medical group for yourself and each enrolled member of your family.
Your PCP coordinates all your care and will refer you to specialists and hospitals within their medical group or Independent Practice Association (IPA).
Women can self-refer for one annual OB/GYN appointment when they choose an OB/GYN who is in the same medical group or IPA as their PCP.
You are required to use HMO (Level 1) coverage for inpatient services such as those provided by hospitals and other medical facilities, hospice agencies, and non-physician healthcare practitioners.

Care from PPO (Level 2) providers

You are responsible for applicable copayments and non-covered charges.
You can see any doctor or specialist in the PPO network for professional services that are provided in a doctor’s office without a referral from your PCP. Only select outpatient services are covered and must be performed in a doctor’s office. Outpatient services include office visits, consultations, evaluations, and treatments. Refer to your Summary of Benefits for more details.