Find care

Not all health care providers accept Medicare-approved amounts as full payment for services (also known as “accepting Medicare assignment”). These providers, known as "non-participating providers,” that don’t accept Medicare assignment can charge more for services, up to 115% of the Medicare-approved amount. The additional 15% is called a limiting charge that applies only to certain services and excludes supplies and equipment. If a non-participating provider bills you for services (called balance billing), the plan will determine what it pays based on the higher of either the Medicare-approved amount or the limiting charge.

For the lowest costs, use providers that accept Medicare assignment whenever possible. To find a Medicare provider go to medicare.gov. If you choose a provider who has opted out of Medicare, you will pay the full cost of the services you receive.

Medicare participating provider — accepts Medicare assignment

Medicare non-participating provider — not contracted with Medicare but will accept Medicare assignment

Opt-out providers 

For information about coverage from providers who opt-out of Medicare and services that are not covered by Medicare, see Benefits Beyond Medicare.

Services not covered by Medicare

For information about services that are not covered by Medicare, see Benefits Beyond Medicare.

UC Health providers are in-network for all UC Medicare Supplement PPO plans. To be certain, first verify with medicare.gov before making your appointment. When you choose UC Health, you choose top-ranked, innovative and state-of-the-art care across the UC Health system. Physicians and researchers collaborate across the six academic health centers to bring systemwide expertise, from primary care services to treating the most challenging and complex cases. Explore more and book an appointment:

• UC Davis Health
• UC Irvine Health
• UC Los Angeles Health
• UC San Diego Health
• UC Riverside Health
• UC San Francisco Health

You can find in-network doctors and other care in your area by logging in to the Anthem member portal anthem.com/ca and select Find Care on the homepage or download the free Sydney Health app from Google Play or the App Store to search on your mobile device. (Learn more about accessing Sydney Health.) 

Within the search box at the top of the page, enter the type of provider you’re looking for, such as family practice, and your location (city, county, or ZIP code).

1. Choose a doctor to see more information, such as training, specialties, languages spoken, address, and phone number.

For non-emergency care, LiveHealth Online virtual care doctors can diagnose, hundreds of conditions, follow up on previous care and coordinate labs for you. Plus, you can access mental health care through video visits to support your whole health and well-being. Doctors are available 24/7 all year long. In most cases, you can speak with a therapist within four days.

To speak with a doctor or therapist, register with LiveHealth Online and schedule an appointment. Learn more about LiveHealth Online services and costs.

Retail clinics

Your Benefits Beyond Medicare coverage includes on-site health clinics at retail pharmacies for evaluation and treatment (including prescribing medicine) of many minor conditions, such as flu and cold, rashes, minor allergic reactions, pinkeye, urinary tract infections, and minor cuts and burns.

Urgent care

If it’s not an emergency but you need care quickly, consider visiting an urgent care center — which can save you time and money. Many urgent care centers are open after business hours and on weekends. Urgent care doctors can treat coughs, sore throats, respiratory infections, earaches, back pain, colds, sinus infections, allergies, rashes, and minor cuts and scrapes. To find a Medicare provider offering urgent care, visit medicare.gov.

Available 24 hours a day, 365 days a year, Anthem 24/7 NurseLine takes the guesswork out of health problems. When you call, you get instant access to registered nurses who can help you deal with medical issues 24 hours a day, seven days a week. Call (800) 977-0027 for immediate answers and reliable information about your symptoms and treatment options.

If you are traveling outside of California and need care, Medicare offers coverage nationwide. Visit Medicare.gov to find providers throughout the US.

If you are traveling outside of California and need services covered under Benefits Beyond Medicare (services that are not covered by Medicare but are covered by your UC plan), you can search for providers through the BlueCard program. To find a BlueCard provider, call (800) 810-BLUE or go to the Anthem member portal at anthem.com/ca and select the green Find Care button.

Some specialists — as well as certain treatments and procedures — may require a referral or prior authorization before your first visit.

All of the PPO plans include worldwide coverage through Blue Cross Blue Shield Global Core.

Non-emergencies: For routine or non‑urgent medical needs while abroad, visit bcbsglobalcore.com or download the BCBS Global® Core app. Enter "U5X" as the 3-digit prefix of your member ID number. You can search for contracted providers and hospitals in your destination country.

Tip: Using an in‑network Global Core provider increases the chance that Blue Shield can issue a Guarantee of Payment, reducing or eliminating upfront costs.

Emergencies: Go straight to the nearest hospital. As soon as you're able, have the provider, a traveling companion or yourself contact the Blue Cross Blue Shield Global Core Service Center at +1 (804) 673-1177 (24/7; collect calls accepted) to help coordinate your care and arrange Guarantee of Payment, so you are responsible for paying only for your deductible, copay or coinsurance. If a Guarantee of Payment cannot be arranged, you may need to pay the full cost at the time of service.

Paying for care

Providers outside the U.S. may require upfront payment.

• Call the Global Core Service Center as soon as possible if you know you will need treatment. They will attempt to arrange Guarantee of Payment with the provider, which means you would only need to pay your deductible or coinsurance at the time of service.
• Always ask for an itemized bill and a detailed list of the services received and charges for each.

Filing claims

If you paid upfront for services

• Submit a claim to Blue Shield of California for reimbursement (minus any deductible, copay or coinsurance).
• Claim forms and instructions are available on bcbsglobalcore.com or see the Global Core program brochure [PDF]. [note this is a different pdf than for non-Med]

Prescriptions: You pay the full cost of the prescription drugs upfront. Keep itemized receipts and other documentation and request reimbursement from Navitus for the cost, minus your applicable copayment. Prescription drug reimbursement does not apply to Medicare PPO without Prescription Drug members.

Travel vaccines

Your UC Medicare Supplement PPO plan covers most FDA-approved vaccines, including hepatitis A, hepatitis B, meningitis, polio, Japanese encephalitis, rabies, typhoid, and yellow fever, when received in a doctor’s office. Certain travel immunizations are also covered by your Navitus pharmacy benefit.

Review the U.S. Centers for Disease Control and Prevention’s Travel Health Notices for information about current health issues and vaccine and other recommendations for your destination.

Vaccine options

Doctor’s office: Check with your provider to see if they stock and administer the CDC-recommended vaccines for where you are traveling. UC travel clinics: On-site travel vaccine services are available at at the UCSF SFO Airport Medical Clinic, UC San Diego, and UCLA.

Retail pharmacy: Visit any Navitus network pharmacy. Many Walgreens and CVS MinuteClinics also stock or can order travel vaccines. Find a pharmacy on the Navitus portal.