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

There are no changes to out-of-pocket costs for UC Blue & Gold HMO. There are a couple of changes to benefits.

Pharmacy

In accordance with a change in state regulations, all substance abuse disorder medications will be placed on tier 1, without prior authorization or step therapy. 

Omada diabetes prevention program

UC members are able to access the Omada program for up to two years, instead of indefinitely. Participants nearing the two-year mark will be notified via email at 30 days, 14 days, and 1 day prior to their account closure to ensure they’ll have ample time to save lessons, conversations and resources.

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, 2020, 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
$58,000 and under $50.64 $91.15 $166.95 $207.46
$58,001–$114,000 $88.82 $159.87 $254.11 $325.17
$114,001–$171,000 $128.00 $230.39 $332.22 $434.62
$171,001 and above $168.57 $303.42 $413.15 $548.00
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