CalPERS has partnered with Included Health and Blue Shield of California (BSC) to enhance the PPO health care experience for Basic PPO members starting January 1, 2025. This new partnership is dedicated to ensuring you receive the highest quality care for your unique needs.
If you’re a Medicare member, your provider network and care coordination services provided by your doctors are not changing.
What Does This Mean?
- Included Health will offer 24/7 access via phone, online, or app for health care navigation, care coordination, and tailored assistance. Services include help finding in-network providers, assistance understanding your medical bill, and access to expert medical opinions. You’ll also have access to virtual primary care, urgent care, and behavioral health care services, as well as a 24/7 nurse advice triage.
- Blue Shield of California will manage claims, provider networks, and offer programs like the Diabetes Prevention Program and value-based care options to lower out-of-pocket costs for certain medical services.
- The collaboration is designed to ensure better access to care, improve care coordination and care management, and help members understand their benefits and costs.
- There are no changes to services for pharmacy benefits through OptumRx.
What Is Included Health?
Included Health is your first stop for comprehensive, personalized health care and aims to improve the health care and health care experience for our Basic PPO members through increased support and care coordination, with a focus on primary care, care management, and increased access to care.
How Can I Be Ready for the Change?
Review our Frequently Asked Questions page for more details.
Health plan ID cards will be mailed to you mid-December. If you do not receive your ID card by January 1, 2025, contact Included Health if you are in a PERS Gold or PERS Platinum Basic PPO plan.
Starting now, you can confirm whether your provider is in-network:
- Call: Included Health’s dedicated line for CalPERS PPO Basic members at 855-633-4436
- Visit: includedhealth.com/calpers
- Download: The Included Health app for easy access to your health plan information on the Apple Store or Google Play Store
- Use: The Health Plan Search by ZIP code tool on our website or in your myCalPERS account