UC Blue & Gold HMO (Health Maintenance Organization) has 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

Health Net Blue & Gold HMO is getting a new name in 2019 — UC Blue & Gold HMO. Health Net will continue to administer medical benefits for the plan.

Behavioral health

Managed Health Network (MHN), a Health Net company, will replace Optum Behavioral Health as administrator of UC Blue & Gold HMO’s behavioral health benefits, effective Jan. 1, 2019. For questions about the behavioral health transition, including support available to you for transition of care, call MHN at 800-663-9355.

Some specialty behavioral health services, such as psychological testing and Applied Behavioral Analysis (ABA), will be covered without a copay for each visit beginning in 2019.

New options for care

UC Blue & Gold members will have access to care in select CVS MinuteClinic walk-in locations, with a $20 copay for routine visits and $0 copay for preventive care. 

Sutter Gould physicians and their affiliated hospitals in the Central Valley are also joining the Blue & Gold network, making the plan a more convenient option for UC Merced faculty and staff.

Telehealth services, including visits with psychiatrists, will be available through Teladoc instead of MDLive.

UC Blue & Gold HMO 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.

You choose a doctor in the Blue & Gold HMO network to coordinate your care and refer you to a specialist when you need one.

Pharmacy

Pharmacists must dispense a prescription for Schedule II controlled substances as a partial fill, if requested by the patient or physician, with the copayment prorated accordingly. No additional fees can be assessed for subsequent partial fills if the full copay was collected at the first partial fill.

Health Benefit Navigator

Health Net's Health Benefit Navigators, a team of 59 dedicated staff available Monday through Friday from 8 a.m. to 8 p.m., will provide enhanced customer service for UC Blue & Gold HMO members. Members can speak to a Health Net Navigator at 800-539-4072.

New ID Cards

In late December, you and each covered family member will get one ID card from Health Net that you’ll use beginning Jan. 1, 2019, for medical, prescription drug and behavioral health services. 

How the plan works

  • You pay a copayment for prescription drugs and some services.
  • The plan covers the cost of services only if your medical group authorizes them.
  • UC Blue & Gold provides coverage for services outside of your medical group only in cases of emergency.
  • In-network behavioral health benefits are provided by MHN.

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
$56,000 and under $40.88 $73.58 $146.70 $179.40
$56,001–$111,000 $76.93 $138.47 $229.00 $290.54
$111,001–$167,000 $113.93 $205.07 $302.76 $393.90
$167,001 and above $152.24 $274.03 $379.18 $500.97
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