HMOs offer members a range of health benefits, including preventive care, for a monthly fee, with no deductibles or maximums. They also set copayments for the care you receive. The HMO will give you a list of doctors for your use in choosing a primary care physician (PCP). The PCP coordinates all your care, including referrals to a specialist. If you go outside of the HMO without a referral from the plan, you'll be responsible for the total cost of services, except for emergencies or urgent care services. HMOs are available only in designated California services areas.
The following link provides you with a summary and comparison of plan benefits and copays. Please refer to each plan’s Evidence of Coverage (EOC) booklet for the exact terms and conditions of coverage. In case of a conflict between this summary and your plan’s EOC, the EOC booklet determines the benefits that will be provided.
|Blue Shield HMO||Kaiser Permanente|
Blue Shield Net Value
Blue Shield NetValue Information
Telephone #: (800) 334-5847
Evidence of Coverage (EOC) Brochure: Blue Shield NetValue (same coverage as Blue Shield Access+)