UC Blue & Gold HMO
Administered by Health Net
UC Blue & Gold is an HMO (Health Maintenance Organization) with a custom network of providers created exclusively for UC. The Blue & Gold network includes all UC medical centers and medical groups, along with coverage in 30 California counties.
The information below is a summary. See plan documents for details.
- Full Full eligibility available
- Mid Mid eligibility available
- Core Core eligibility available
- Retirees Retirees eligibility available
New for 2026
Employee premiums will change for more equity across plans
In the past, UC covered a larger share of the total cost for Kaiser HMO compared to other plans with similar benefits. Beginning next year, UC is balancing employee premiums across similar health plans. Plans with provider choice, including in-network UC Health providers, will be more affordable overall. Premiums for represented employees will be implemented consistent with applicable collective bargaining agreements and the law.
Coverage for weight loss medications will be more limited
Coverage of medications such as GLP-1s for weight loss will be limited to individuals with a body mass index of 40 or above. Some exceptions may be possible for those continuing a course of treatment. UC medical plans will continue to cover GLP-1 medications for the treatment of Type 2 diabetes. Please see your plan documents for details.
HMO plan coverage for infertility services and prescriptions will expand
As mandated by California state guidelines, coverage for Kaiser CA HMO and UC Blue & Gold HMO will include up to three completed oocyte (egg) retrievals per lifetime and unlimited embryo transfers of IVF, GIFT and ZIFT per member.
Infertility services and prescriptions will be covered at the plan-specific cost share and pharmacy tier, making them more affordable for HMO members trying to grow their families. Infertility costs will accrue to the annual out-of-pocket maximum.
- You choose a primary care doctor (PCP) and participating provider group (PPG) or medical group in the UC Blue & Gold HMO network to coordinate your care and refer you to a specialist when you need one.
- 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.
- The UC Blue & Gold HMO provides coverage for services outside of your medical group only in cases of emergency and urgently needed services.
- In-network behavioral health benefits are provided by Health Net Behavioral Health.
- See updated information about coverage for COVID tests.
- You and the family members you cover live in California
- You want low, predictable out-of-pocket costs
- You like having one doctor manage your care
- You are happy with the selection of providers