Blue Shield of California

Stability

Blue Shield of California, an independent member of the Blue Shield Association, is a not-for-profit health plan dedicated to providing Californians with access to high quality care at an affordable price. Founded in 1939, it now has 3.2 million members, 4,500 employees, one of the largest provider networks and more than 20 office locations, providing a wide range of commercial and government products throughout the state. The company contributes $30 million annually to the Blue Shield of California Foundation to fund nonprofit organizations that improve access to quality health care in California.

Extensive Network

By choosing a Blue Shield plan, you have easy access to the quality physicians, specialist and hospitals you want and need. Our providers meet stringent credentialing standards and include some of the most prestigious physician and hospitals in the state. Our PPO, HMO, dental and vision networks are among the largest in California, giving you greater access and choice. Add to that our Blue Card program featuring 85% of all U.S. providers and more than 50,000 providers in 200 countries and you are covered almost anywhere you go.

"Excellent" Quality Accreditation

The National Committee for Quality Assurance (NCQA) awarded our HMO and POS plans its highest accreditation- -"Excellent"--for service and clinical quality. This accreditation is reserved for the best health plans in the nation and is awarded only to plans that meet or exceed the NCQA's rigorous standards.

Discount Programs

As a Blue Shield member, you can participate in Wellness Discount Programs **, a variety of healthy-lifestyle products and services like massage and chiropractic sessions, acupuncture, even a popular weight management program. The programs offer significant discounts - some up to 25 percent.

blueshieldca.com

Our award-winning blueshieldca.com Web site can help you better manage both your health and your health plan. Whether you want to find a doctor or learn more about plan benefits, treatment options, prescription drugs or our wellness programs, blueshieldca.com has what you need.

Nurses and Counselors Available by Phone and Online

If you are an individual member or your employer chose this service, as a Blue Shield member you will have round- the-clock access to medical information from a registered nurse by phone or online. You can also talk to Master's- level counselors for support with work and personal issues. Our specialists have resources for senior care, childcare and even financial counseling and legal advice. All communications are completely private and available 24 hours a day, seven days a week.

Compare Hospitals and Treatment Options

Compare hospitals, investigate treatment options and find out more about prescription or over-the-counter drugs through our new Lifepath Decision GuideSM. This innovative guide is the first of its kind in California. All of the guide's resources are available to Blue Shield members anytime, at no extra cost.

Here is some Great News!

If you are currently a member of the Greater San Diego Chamber of Commerce or plan on becoming one, your small group(6 or more employees) may be eligible for special RAF(see what is the risk adjustment factor) promotion only afforded to Chamber members. Make sure you ask your broker at Nico Insurance Services Inc., about the requirements.

Health and Wellness Programs

We've developed a suite of health management programs to help you feel better and stay healthier. When you participate in our specialized programs, such as those for asthma or diabetes, you'll get practical resources and support at no extra cost.

*HMO members are only covered out of network for urgent and emergency care

**Wellness Discount Disclaimer

These discount program services are not a covered benefit of Blue Shield health plans and none of the terms or conditions of Blue Shield health plan applies.

The network of practitioners and facilities in the discount programs are managed by the external program administrators identified below, 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 health plan covered benefits. Members should access those covered services prior to using the discount program.

Members are responsible for following the payment and appointment policies of external discount programs and practitioners, including those for cancelled or missed appointments. Blue Shield is not responsible for any portion of the costs associated with services accessed through the discount programs. Costs incurred by Members through these programs do not count towards their Blue Shield health plan deductible or copayment/out-of-pocket maximum.

Members who are not satisfied with products or services received from the discount program may use the Blue Shield's grievance process described in the Grievance Process section of the Evidence of Coverage or Certificate of Insurance. Blue Shield reserves the right to terminate this program at any time without notice.

The Alternative Care Discount Program is an exclusive offer to Blue Shield members, made available through an arrangement with American Specialty Health Networks of California, Inc. (ASH Networks) and is not a covered service of any Blue Shield health plan. ASH Networks credentials and manages the program's practitioners. None of the terms and conditions of Blue Shield health plans apply. Blue Shield of California and ASH Networks do not review the program's practitioner services and products for medical necessity or efficacy and makes no representations, claims or guarantees regarding their services or products. Members who use the discount program are responsible for the payment of services provided by participating network practitioners, including payment for cancelled or missed appointments. Members who are not satisfied with services received from the program's practitioners may use the Blue Shield grievance process. Blue Shield reserves the right to terminate this program without notice.

Contact Info

  • Phone: (619) 667-2111
  • Fax: (619) 667-2100

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