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2023 Medical Plans

We offer a selection of plans that can help you and your family stay healthy. 

All of the medical plans provide comprehensive coverage, including preventive care, preexisting conditions, hospital stay, prescription drug, as well as mental health services. Your monthly costs and out-of-pocket expenses will vary based on the plan and coverage level you select.

Blue Shield of California Medical and Pharmacy Plans

Transparency

in Coverage

Blue Shield of California and Kaiser provide machine readable files that are made available in response to the federal Transparency in Coverage Rule and includes negotiated service rates and out-of-network allowed amounts between health plans and healthcare providers. The machine-readable files are formatted to allow researchers, regulators, and application developers to more easily access and analyze data.

Blue Shield of California Pharmacy Benefits

Blue Shield of California Drug Formulary List (Plus Formulary)

Doctor
  • Blue Shield of California PPO Plans including HDHP, provides coverage for in-network and out-of-network care, and you do not need to select a Primary Care Physician (PCP) for care coordination.

  • The Blue Shield HDHP plan is HSA qualified, which allows access to a tax-advantaged Health Savings Account (HSA).

  • The HSA is a bank account that allows you to set aside pre-tax dollars to help you pay for eligible health care expenses. 

  • Blue Shield Access+ HMO plan is available to California employees only.

Kaiser Medical and Pharmacy Plans (CA Only)

Kaiser Preventive Care 

Kaiser Summary of Preventive Care Services

Kaiser Pharmacy Benefits

Kaiser Drug Formulary List

Glossary

HDHP+HSA

Pulmonx offers High Deductible Health Plans (HDHP) through Blue Shield and Kaiser. The HDHP is a Health Savings Account (HSA) - qualified medical plan that can be paired with a HSA or can be enrolled as a stand-alone HDHP medical plan.

 

The HDHP offers coverage when you visit in-network or out-of-network providers without requiring a referral from a Primary Care Physician (PCP).

PPO

PPO means Preferred Provider Organization. A PPO medical plan offers allows you to access care with in-network or out-of-network providers. A PPO plan does not require a referral from your Primary Care Physician (PCP) to see a specialist..

  • Kaiser is available to employees who live in California only.

  • Kaiser is a Health Maintenance Organization (HMO) that provides patient services, hospitalization, supplies and prescription drugs through its own network of doctors, hospitals and other Kaiser-affiliated health care facilities.

  • Kaiser covers your expenses only if you go to a Kaiser provider or facility. You are also covered if you have a life threatening emergency when you are outside of a Kaiser service area.

  • Once enrolled, you will select a Primary Care Physician (PCP) to manage your care within Kaiser’s network and to refer you to specialists.

  • The Kaiser HDHP plan is HSA qualified, which allows access to a tax-advantaged Health Savings Account (HSA).

HMO

HMO means "Health Maintenance Organization." HMO plans offer a wide range of healthcare services through a network of providers who agree to supply services to members.  You're required to coordinate your care through a Primary Care Physician (PCP) when you are enrolled in an HMO. A referral is required through your PCP to see a specialist under an HMO plan.

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