Learn about your health benefits
Access+ HMO plan

Plan highlights

The Access+ HMO® plan is affordable and predictable – you pay only the copayment for most covered services like doctor visits, urgent care and emergency care. Your primary care physician (PCP) coordinates all your care as well as refers you to specialists and hospitals within their medical group/Independent Practice Association (IPA).

When you enroll in the 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.
Away From Home Care program
The Away From Home Care® program gives HMO members who are students, long-term travelers, workers on extended out-of-state assignments, and families living apart the convenience and flexibility of coverage for extended periods across the country. To learn more about Away From Home Care and whether your family is eligible, please call Shield Concierge. Please note that Away From Home Care is not available in all areas and states, and benefits from the host plan may differ from the benefits in the Access+ HMO plan.
Emergency and urgent care outside California
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. To locate a BlueCard provider, please call (800) 810-BLUE or go to Find a Doctor.
Shield Spectrum Preferred Provider Organization (PPO) plan

Plan highlights

With the Shield Spectrum PPOSM plan, you can see any doctor you choose for most services. You can also self-refer to specialists. You will usually pay less for services that are provided by PPO network providers.

For most services, you will need to meet the plan’s deductible before Blue Shield begins coverage. Once your deductible is met, you’ll pay a copayment or coinsurance for most services and your out-of-pocket costs will be based on whether you see network or non-network providers. You will usually pay less when you use network providers.
Care away from home
Through the BlueCard Program® and BlueCross BlueShield Global Core, you have access to care across the United States and urgent and emergency care around the world. You can receive urgent or emergency care from any provider. However, using a BlueCard provider can be more cost-effective.