CCSB: Blue Shield PPO Members will be Matched to a Primary Care Physician

Starting January 1, 2021, all members enrolled in a Blue Shield of California PPO will be matched with a Primary Care Physician (PCP) during open enrollment. Blue Shield will match that member with a designated PCP taking many factors into consideration such as cost, physician rating, location and claim history. Members will first see their PCP match via their dashboard when logged in to blueshieldca.com, starting January 1. Communications directly to members will begin in the Spring, informing them of their match. Unlike HMO plan members, ID cards for PPO plan members will not display the name of the PCP.

All members enrolled in a Blue Shield PPO are not required to seek care from their matched PCP, nor are they required to seek a referral for another specialist or physician. Members can change their PCP selection at any time by visiting blueshieldca.com or by using the Blue Shield mobile app to login to their account and use the find a doctor tool.

Having a designated primary care doctor has shown improved access to care for members. This update is part of Blue Shield’s ongoing efforts to provide members with high quality care.

An email communication on this update will be sent to Covered California for Small Business Employer Groups identified as having employees actively enrolled in a Blue Shield plan.

As a helpful resource, Blue Shield has provided a frequently asked questions guide for this update. Click here to view or download this guide.

For questions, please contact a member of your B&P Sales Team - 888.722.3373.