Switching your IFP medical plan

Before you make any plan changes, consider the following:

Whether you purchase a Blue Shield plan direct from us or through Covered California, you will still have access to the same provider network – Exclusive PPO or IFP Trio HMO. You will also have access to the same drug formulary (Standard Drug Formulary) for individual and family plans (IFP).

Decide if you need financial help

You may be eligible to get financial help. To get the subsidy, you will have to enroll in a health plan sold through Covered California. If you don’t need or don’t qualify for financial help, you won’t be required to enroll with Covered California.

Choose a provider network

When changing plan types, such as changing from a PPO plan to a Trio HMO plan, you will want to make sure that your preferred provider is available in your new plan’s network because there are differences between each plan type’s network.

Find a new plan

Comparable plans

If you are happy with your current Blue Shield plan, you may be able to keep it and use the subsidy. Blue Shield has available plans with the same plan benefits that are available through both Blue Shield and Covered California:

Plans with nearly identical benefits available through Blue Shield or Covered California

What is the difference between the Silver 70 plans sold through Covered California and the plans I can purchase directly from Blue Shield?

Blue Shield’s Silver 70 Off Exchange PPO or Trio HMO plans are nearly identical to the Silver 70 plans available through Covered California. The only difference in benefits between the Silver 70 plans is that your cost share for emergency medical transportation is slightly more than the Off Exchange plan.
 

Cost Sharing Reduction plans

Cost-sharing reductions (CSRs) enhanced Silver plans are available only through Covered California if you qualify based on your income. If you are eligible, you pay less for your out-of-pocket expenses such as deductibles, copayments, and coinsurance when you use your plan. You will also qualify to pay less on your monthly premium by qualifying for a subsidy.

Plans available only through Blue Shield

Consider purchasing a higher metal plan with more benefits

If you currently have a plan direct from Blue Shield and you cannot find its Blue Shield equivalent through Covered California, you may want to consider purchasing a higher metal plan with more benefits.

For example, if you have a Silver 1750 plan, you may find that you can purchase a Blue Shield Gold 80 plan and receive more benefits including a lower deductible. If you are enrolled in the Bronze 7500 Trio HMO plan, you should consider one of our Silver Trio HMO plans. 

After you decide to switch plans, follow these steps for a smooth transition:

Apply for your new medical plan 

Once you are ready to enroll in your new plan, contact your broker. If you don’t have a broker, call us at (888) 508-7872 (TTY: 711), 8 a.m. to 5:30 p.m., Monday through Friday.

What you need when you switch to Covered California

Make sure you have the information or documents below ready when you call to enroll in a new medical plan through Covered California:

• Employer and income information (employment, self-employment, income tax deductions, or other types of income.
• Social security numbers for all applicants
• Immigration documents for non-citizens
• Federal tax information for head of household and any dependents
• Have the initial payment for the first month's premium of your new medical plan paid‡

In the meantime, you will also need to continue to pay your monthly premium for your current medical plan through the last month of coverage. 

For example, if you purchased a new medical plan through Covered California for a January 1, 2026 effective date, you must continue to pay for your current coverage through the end of December 2025 to remain covered. The January premium for the new plan through Covered California must be paid to activate coverage, and then your next bill will be sent for February coverage.

Get a new ID number and medical ID card

Within ten days of paying the initial payment, you will receive a new subscriber ID number and a new ID card for your new plan. If you choose a plan sold through Covered California, your new 2026 ID card will include the Covered California logo. You will need to provide your new ID card when accessing care and filling a prescription in 2026. 

Keep your current subscriber ID number and ID card to continue to access care through the end of the month before your new effective date. If you have a separate Blue Shield dental or vision plan associated with the same ID number, you can continue to use this ID number for the next year for access to your Blue Shield dental or vision plan.

If you have a Trio HMO plan, be sure to choose your Primary Care Physician

When you enroll in a new Trio HMO plan, you should choose your primary care physician (PCP) during enrollment. Your preferred physician will be listed on your ID card.

If you don’t choose a PCP at enrollment, you will be assigned a virtual PCP through Accolade Care, a virtual medical group. If you’d like to make a change before your plan is effective, call Shield Concierge at (844) 250-2872 (TTY:711). Once your new plan is effective, you can log in to your online account to make future changes. For more details on changing your PCP, visit blueshieldca.com/triopcp.

Get online access for your new medical plan

If you have already registered for online account access, your new plan will be associated with your previous account registration, however you will need to register. Please be sure to keep your current login credentials associated with your previous medical plan.

If you have not registered online, you can register for a new online account up to 90 days prior to your plan’s effective date. 

If you also have Blue Shield dental or vision coverage under the same login and subscriber ID number as your previous medical plan, you can continue to use that same login to access your dental or vision plan information.

Manage Autopay for your new medical plan

Any existing autopayments will only be applied to your current coverage. These autopayments will not be transferred to your new medical plan, and they will continue unless you proactively cancel them or cancel your coverage. 

To continue automatic payments for your new medical plan, you will need to re-enroll in autopay after your new medical plan is effective, using your new subscriber ID and new login credentials. 

Also, because you had to make an initial payment for the first month’s premium during enrollment, your next autopayment withdrawal will be made when the premium for the second month of coverage is due.# 

If you have a dental or vision plan already set up with Autopay under the same subscriber ID as the medical plan you will no longer need, you may continue to use the current autopay program and current login credentials to access your bills. Automatic payments will be adjusted to reflect the monthly premium due for your dental or vision plan once the medical plan is cancelled. 

Call Customer Service to cancel your renewal medical plan

You must call Customer Service, (855) 836-9705 (TTY:711), to have them cancel your current medical plan because, legally, Blue Shield cannot cancel your plan without your authorization. Failure to cancel your plan will result in you having two active plans and two sets of bills. 

Be sure to cancel by calling: 

• The month before your new medical plan is effective, and 
• After you have paid for the last month of coverage on your current medical plan.

Prepare for your care needs

When you switch plans, make sure the following is in place to continue your access to care: 

• If you are receiving care or have any prescriptions that require prior authorization, you can call Customer Service, and they will make a request with your provider to transfer the prior authorization to your new Blue Shield plan under your new subscriber ID number.
• When your new medical plan is effective, fill your prescriptions using your new medical ID number. 
  • Provide your new medical ID number to your pharmacy. Prescriptions and authorizations set up with the previous medical plan will not automatically transfer to the new plan. 
  • Contact your provider if you need a new prescription order for any drugs or medical equipment.
  • Make sure to double-check any mail order prescriptions by providing your new medical ID number to the mail order pharmacy. 

Keep your dental plan, vision plan^∞, or life insurance plan^∞ with Blue Shield

If you already have a Blue Shield dental, vision, or life insurance plan that was sold directly through Blue Shield, we recommend you stay enrolled in those plans. You will not need to cancel these plans if you switch to a medical plan sold through Covered California. Just continue to pay your bills. 

If you enroll with Covered California for a medical plan, you will be given the opportunity to enroll in a dental plan through Covered California. You can omit that step during the enrollment process and keep your current Blue Shield dental plan. If you aren’t currently enrolled in a Blue Shield dental plan, consider enrollment in a Family Dental PPO or HMO plan. Financial help only applies to medical plans.

If you don’t currently have a Blue Shield dental plan, you can also purchase a Blue Shield Family Dental plan through Covered California. Consumers cannot purchase a Blue Shield vision or life insurance plan through Covered California.

If you choose to purchase a new Blue Shield medical plan through Covered California, you will receive a separate bill for your Blue Shield dental, vision and/or life insurance plan(s). This means you will have a separate login to access your new medical plan from your dental or vision plan (as noted in "Register for online access for your new medical plan" above). This will be the case whether you purchase dental through Covered California or through Blue Shield. You will also have to manage separate autopayment programs for your medical plan from your dental or vision plan (as noted in "Manage Autopay for your new medical plan" above).

^* Subsidy is not available with the Blue Shield Minimum Coverage PPO plan.

† A high-deductible health plan that is Health Savings Account (HSA) compatible.

‡ When you enroll in your new Blue Shield medical plan through Covered California, a new policy and ID number will be issued, and you will need to pay the first month’s premium (initial payment) for your new coverage. Once your initial payment is received, you will receive a welcome letter that confirms your enrollment is complete and includes the date your new medical plan will be effective. 

^# Timing for autopayment withdrawal is dependent on when you re-enroll.

∞ Underwritten by Blue Shield Life & Health Insurance Company (Blue Shield Life).