- Retirees
- Benefits for retirees
- Retiree health & home benefits
- Medical plans for retirees
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UC Care for retirees
UC Care for retirees
UC Care is administered by Blue Shield of California (medical) and Navitus (pharmacy); supported by Accolade Health Care Advocate
UC Care is a PPO plan created just for UC to ensure the best possible access to world-class UC hospitals and physicians.
For convenience and flexibility, you also have access to the Blue Shield network of providers, as well as coverage for non-network providers.
The information below is a summary. See plan documents for details.
Open Enrollment for 2027 benefits begins on Thursday, Oct. 29 at 8 a.m. and ends on Friday, Nov. 20 at 5 p.m. See below for a few changes to UC Care benefits and costs.
- Full Full eligibility available
- Mid Mid eligibility available
- Core Core eligibility available
- Retirees Retirees eligibility available
- Monthly premiums will increase. ALEX is the best resource to understand your specific costs.
- Accolade is becoming Transcarent, with a new app, tools and features to help you understand benefits, find care and get answers to health care questions. Usernames, passwords, and all Accolade information and support history will carry over to the new app, and the same phone number will remain available for help.
- Behavioral health office visits with Tier 1 providers will continue to have a $30 copay. Tier 2 providers will be 30% coinsurance, up to a maximum of $30. Next year, the copay and coinsurance will apply beginning with the first visit.
- Tier 1 Network Changes: The following facilities in Los Angeles, California, will no longer be in the Tier 1 network: St. Mary Medical Center Long Beach; PIH Health Downey Hospital; Whittier Hospital Medical Center; PIH Health Good Samaritan Hospital. These facilities will move to Tier 2 starting Jan. 1.
- High-risk human papillomavirus (hrHPV) testing for cervical cancer will be designated as the preferred screening method for average risk women ages 30-65, and additional follow-up testing will be covered at $0 cost share.
- All members will receive new ID cards with both medical and pharmacy information.
How the plan works
For questions about medical coverage, claims, finding providers and more, start with Accolade. Call (866) 406-1182 (Monday–Friday, 5 a.m.–8 p.m. PT) or visit the Accolade member portal.
For questions about prescription drug coverage and costs, call Navitus Customer Care at (833) 837-4308 or visit the Navitus member portal.
Register for a monthly Accolade webinar to learn how your PPO works and how Accolade can help. Find all your plan details on the UC Faculty and Staff PPO plans website.
- You may choose any doctor or care facility, worldwide. You pay less for care within the Blue Shield Tier 1 (UC Select) or Tier 2 networks.
- Annual out-of-pocket maximums limit what you pay. If you reach the annual maximum, the plan pays 100% of your covered medical costs for the rest of the year.
- Behavioral health benefits are provided through Blue Shield.
- Learn more about getting care outside California and the U.S.
- See updated information about coverage for COVID tests.
Best fit for you if:
- You want direct access to most providers without a referral
- You want no deductible and fixed copays for using providers in the Tier 1 (UC Select) network
- You want coverage when you are traveling or living abroad
- You and/or your family members live outside California
Understanding your costs
When choosing a plan, make sure to consider all your costs, including your monthly premiums and what you can expect to pay out-of-pocket for care. ALEX will ask you a few questions to help you estimate how much you may need to spend.
Learn more about what you pay for care on the UC Faculty and Staff PPO plans website.
- Blue Shield Tier 1 (UC Select) network (available only in California): You pay set copayments for covered services, and there’s no deductible. The annual out-of-pocket maximum is $6,100 for individual coverage and $9,700 for family coverage.
- Office visits/urgent care: $30
- Emergency room visits: $300
- Hospital stay: $250
- Navitus network pharmacies:
- Tier 1: $10
- Tier 2: $30
- Tier 3: $50
- Blue Shield Tier 2 network: You pay 30% of the cost of service after the deductible has been met.
- Individual coverage: $500 deductible; $7,600 out-of-pocket maximum
- Coverage for a family of three or more: $1,000 deductible; $14,200 out-of-pocket maximum
- Non-preferred or out-of-network: After the deductible has been met, you pay 50% of the allowable cost of service plus any billed charges that exceed the allowed amount.
- Individual coverage: $750 deductible; $9,600 out-of-pocket maximum
- Coverage for a family of three or more: $1,750 deductible; $20,200 out-of-pocket maximum
*UC Care deductible and out-of-pocket maximums do not cross-accumulate for in-network and out-of-network services. The UC Select and Anthem Preferred (transitioning to Blue Shield next year) out-of-pocket maximum do cross-accumulate.
| Pay Band (full-time salary rate) | Self | Self + Child(ren) | Self + Adult | Family |
|---|---|---|---|---|
| $73,000 and under | $130.85 | $235.52 | $403.08 | $507.76 |
| $73,001–$145,000 | $189.17 | $340.50 | $525.55 | $676.89 |
| $145,001–$217,000 | $247.49 | $445.47 | $648.02 | $846.01 |
| $217,001 and above | $305.80 | $550.44 | $770.48 | $1,015.13 |
Enrolling in Medicare
UC Medicare PPO is considered the “partner plan” of UC Care. That means that if you are a retiree enrolled in UC Care, you’ll be transferred into UC Medicare PPO when you turn 65, once Medicare has approved your enrollment form.
Plan documents and contacts
- Documents and forms
- UC Faculty and Staff PPO Plans website
- Accolade member portal
- Blue Shield of CA provider search for UC Care
- Accolade Health Care Advocate: 866-406-1182
- Navitus: 833-837-4308