Health Net Blue & Gold is an HMO (Health Maintenance Organization) with a custom network of providers created exclusively for UC. The Blue & Gold network includes:

  • Over 240 hospitals, 10,000 PCPs and 26,100 specialists
  • Coverage in 30 California counties
  • All UC Medical Centers and medical groups

Plan changes

There are no major plan changes for 2018. However, cost sharing is eliminated for low- to moderate-dose statins for cardiovascular disease prevention, provided certain criteria are met.

Health Net Blue & Gold members in the San Francisco Bay Area can continue to benefit from the Canopy Health alliance formed between Hill Physicians-SF (UCSF), John Muir Health, Meritage Medical Network and the affiliated hospitals. If you choose a primary care physician (PCP) within one of these medical groups, you will have access to the entire Canopy Health alliance and your PCP can offer referrals to any clinically appropriate specialist within Canopy Health.

How the plan works

  • You choose a doctor in the Blue & Gold HMO network to coordinate your care and refer you to a specialist when you need one.
  • You pay a copayment for prescription drugs and some services.
  • The plan covers the cost of services only if your medical group authorizes them.
  • Health Net Blue & Gold provides coverage for services outside of your medical group only in cases of emergency.
  • In-network behavioral health benefits are provided by Optum.

Best fit for you if:

  • You want low, predictable out-of-pocket costs
  • You like having one doctor manage your care
  • You are happy with the selection of providers

Monthly plan costs for faculty and staff

Retiree plan costs chart »

Pay Band
(per annum)
Self Self +
Child(ren)
Self +
Adult
Family
$54,000 and under $39.57 $71.22 $142.78 $174.44
$54,001–$107,000 $75.62 $136.11 $225.08 $285.58
$107,001–$161,000 $112.62 $202.71 $298.84 $388.94
$161,001 and above $150.93 $271.67 $375.26 $496.01
Rates for union-represented employees are subject to ongoing collective bargaining as appropriate.


Typical out-of-pocket costs

  • Office visit/urgent care visit: $20 (preventive care has no charge)
  • Emergency room: $75
  • Hospital stay: $250
  • Prescription drugs: $5 generic; $25 brand name; $40 non-formulary