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San Bernardino County
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Choose from two popular mental health apps
You have a choice between Headspace and Headspace Care (formerly Ginger) through Wellvolution®
- Headspace® offers guided meditations on topics like stress and resilience, sleepcasts, yoga workouts, and other features
- Headspace CareTM offers on-demand, confidential mental health support day or night through coaching, self-guided activities, and more
Discover Virta
Helping set a new standard of medical care for people living with type 2 diabetes and prediabetes.
Virta can help you learn how to improve blood sugar, so you can get back to what you love.
Virta is available at no additional cost to eligible Blue Shield of California members.
Your health plan options
Trio HMO plan
With the Trio HMO plan:
- 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
- 2023 Trio HMO plan documents
- Summary of benefits
- Evidence of coverage
- Resources
- Trio HMO plan highlights video
- Trio HMO overview
Shield Signature plan
You’ll have access to covered services from two levels of benefits: Level I, HMO and Level II, PPO.
With the Shield Signature plan:
With the Shield Signature plan:
- You can choose an HMO, PPO, or out-of-network provider each time you access care. With HMO providers you pay no deductible and only fixed copays. With PPO providers, you pay higher out-of-pocket costs, including a deductible and coinsurance
- Each member of your family must select a primary care physician (PCP) from our broad HMO network
- You can get care from in-network and out-of-network specialists with a PCP referral. However, your costs may be higher if you see an out-of-network specialist
- 2023 Shield Signature plan documents
- Summary of benefits
- Evidence of coverage
Level I: HMO benefits
Your Level I, HMO benefits:
- Deliver the highest level of benefits at the lowest out-of-pocket cost to you.
- Cover most services, as long as care is provided by your PCP or a provider authorized by your PCP.
- Allow women booking their annual OB/GYN appointment to self-refer, when they choose an OB/GYN who is in the same medical group/Independent Practice Association (IPA) as their PCP.
- Require you to receive care under your Level I coverage for inpatient services such as those provided by hospitals and other facilities, hospice agencies, and non-physician healthcare practitioners.
Level II: PPO benefits
Your Level II, PPO benefits provides more flexibility and a wider range of covered professional services that are provided in an office. However, when your access your PPO benefits your share of costs is higher than when you access your Level I HMO benefits.
With your Level II, PPO benefits you:
- Are responsible for applicable copayments and non-covered charges.
- Are only covered for consultation, evaluation and treatment performed in the doctor’s office.
- Can see any doctor or specialist in the Blue Shield PPO network for professional services that are provided in an office without a referral from your PCP.
Important: Your Level I, HMO PCP must coordinate and authorize care under your Shield Signature Level I benefits for:
- Services that require hospitalization
- Outpatient surgery
- Maternity care
- Other therapeutic care
Access+ HMO plan
With the Access+ HMO® plan:
Note: 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)
Note: 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.
- 2023 Access+ HMO plan documents
- Summary of benefits
- Evidence of coverage
PPO plans
- PPO plan
- PPO Savings (Bronze) plan
- PPO Needles plan
With these PPO plans:
- 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
- 2023 PPO plan documents
- Summary of benefits
- Evidence of coverage
- 2023 PPO Savings (Bronze) plan documents
- Summary of benefits
- Evidence of coverage
- 2023 PPO Needles plan documents
- Summary of benefits
- Evidence of coverage
Pharmacy benefits
Access drug coverage information and answers
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.
Find a provider
Virtual resources are available to help you find a provider.
Search for providers in California by multiple criteria such as gender, language and etc.
Shield Signature and Access+ HMO plan
To search for a primary care physician (PCP), select “Primary Care Physician.” You may need your selected PCP’s provider number and medical group/Independent Practice Association (IPA) number when you enroll in the plan for the first time. To find this number, search for your doctor using our Find a Doctor tool. Then, click on your doctor’s name and select View details under Primary Care Physician ID.
To search by doctor type or doctor name, select Doctors instead of Primary Care Physician.
All PPO plans
These PPO plans give you the freedom to choose doctors and hospitals from our broad PPO network and the flexibility to seek care outside the network. You will usually pay less for services from PPO in-network providers.
To search for a primary care physician (PCP), select “Primary Care Physician.” You may need your selected PCP’s provider number and medical group/Independent Practice Association (IPA) number when you enroll in the plan for the first time. To find this number, search for your doctor using our Find a Doctor tool. Then, click on your doctor’s name and select View details under Primary Care Physician ID.
To search by doctor type or doctor name, select Doctors instead of Primary Care Physician.
All PPO plans
These PPO plans give you the freedom to choose doctors and hospitals from our broad PPO network and the flexibility to seek care outside the network. You will usually pay less for services from PPO in-network providers.
Programs and services in the spotlight
Decrease your stress
Fitness Your WayTM offers access to virtual classes, gyms with no long-term contracts, and more.
Wellvolution®
Wellvolution®, our digital platform for health and well-being, offers programs to help you achieve your health goals – at no extra cost. You choose the areas to focus on:
- Prevent and reverse disease – Prevent diabetes and reverse cardiovascular disease and other conditions.
- Eat better – Get help with meal planning, use nutritional calculators, and lose weight.
- Exercise more – Get support with movement tracking, workout routines, and coaching.
- Manage stress – Meditate, practice mindfulness, and more.
- Sleep better – Track sleep patterns and enjoy relaxation exercises for better rest.
- Quit smoking – Get the support you need to stop smoking with nicotine replacement therapy and other methods.
Save yourself a trip to the doctor's office
Teladoc® virtual care
Talk to a board-certified Teladoc® medical doctor or licensed mental health professional by phone or video for a $0 copay.
All programs and services
- 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 from Shield SupportGet support managing conditions such as diabetes and depression.
- CVS MinuteClinic® – available only to PPO plan membersGet walk-in non-emergency health care at CVS MinuteClinics across California.
- 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.
- 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.
- Target Clinics – available only to PPO plan membersGet walk-in non-emergency health care at Target Clinics across California.
- 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.
- Wellvolution® *Access apps and programs to help you reach your health goals.
- Emergency and urgent care outside California (HMO)Through the BlueCard® Program, Access+ HMO members can access urgent care services across the country and around the world. You can receive urgent care services from any provider; however, using the BlueCard Program can be more cost-effective and may eliminate the need for you to pay for the services when they are rendered and submit a claim for reimbursement.
* The wellness discount program services are not a covered benefit of your Blue Shield of California health plan, and none of the terms or conditions of the Blue Shield 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 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, Disclosure Form, Evidence of Coverage and Disclosure Form, or Benefit Booklet. Blue Shield reserves the right to terminate this program at any time without notice.
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.
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.