UC Care is a PPO plan created just for UC. You can get care from UC physicians and medical centers as well as the Blue Shield Preferred network of providers — the choice is yours. You also have coverage for non-network providers.
How the plan works
- You may choose any doctor or care facility, worldwide.
- You have two options for in-network care:
- You pay set copayments for covered services and there’s no deductible when you use providers in the UC Select network.
- You also can choose a provider in the Blue Shield Preferred network and pay 20 percent of the cost of service.
- There is a $250 deductible for individual coverage and $750 deductible for a family of three or more.
- Or, you can choose a non-preferred or out-of-network provider and pay 50 percent of the cost. There is a $500 deductible for individual coverage and $1,500 deductible for a family of three or more.
- Annual out-of-pocket maximums limit what you pay. If you reach the annual maximum, the plan pays 100 percent of your medical costs for the rest of the year.
- UC Select: $1,500/individual; $4,500/family
- Blue Shield Preferred: $3,000/individual; $9,000 family
- Out-of-network: $5,000/individual; $15,000 family
- Blue Shield will administer claims.
- Behavioral health benefits are provided by Optum. Optum providers generally have lower costs, but you also may use out-of-network providers. Costs are included in your deductible and out-of-pocket maximums.
Best fit for you if:
- You want direct access to all providers without a referral
- You want no deductible and fixed copay for using providers in the UC Select network
- You want coverage when you are traveling or living abroad
- You and/or your family members live outside California
- You are looking for a plan like Anthem Blue Cross PPO or Anthem Blue Cross PLUS
Monthly plan costs
|Pay Band (per annum)||Self||Self +
|$51,000 and under||Employee Cost
|$151,001 and above||Employee Cost
Typical out-of-pocket costs
Office visit/urgent care visit: UC Select: $20; Blue Shield Preferred: 20 percent; out-of-network: 50 percent; (preventive care with in-network provider has no charge)
Emergency room: $100
Hospital stay: UC Select: $250; Blue Shield Preferred: 20 percent; out-of-network: 50 percent
Prescription drugs: $5, generic; $25, brand name; $40, non-formulary