PERS Choice Health Plan

PERS Choice is a PPO plan that caters to individuals who value freedom of choice. Unlike a health maintenance organization where a primary care physician directs all medical care, PERS Choice allows you to manage your own care. You can see a specialist without a referral and can change physicians whenever you wish. Benefits though are paid at the highest level when the provider you choose is a preferred provider, a provider who participates in the Blue Cross PPO (Prudent Buyer) network. CalPERS contracts with Anthem Blue Cross (formerly known as Blue Cross of California) to provide:

• Claim payment services
• Utilization review services (to make sure certain services are medically necessary as defined by the Blue Cross medical policy)
• Access to an extensive network of physicians, hospitals, and other health care professionals

Learn more about available interactive services and access the current ProviderFinder at Anthem Blue Cross.

We contract with Medco Health Solutions to provide prescription drug services. You can get outpatient prescriptions through either the mail order pharmacy, Medco by Mail, or through Medco's network of retail pharmacies. Visit Medco for additional information and interactive services.

The Evidence of Coverage (EOC) booklet provides detailed information to help you understand the benefits, covered services, deductibles, co-payments, and exclusions of your health plan. The EOC highlights include:

The Basic plan covers active employees and retired members not eligible for Medicare. The Supplement to Medicare plan is for members enrolled in Parts A and B of Medicare. Medicare is your primary insurance coverage, and your CalPERS plan "supplements" coverage for charges not covered under Medicare. Your plan also offers benefits not covered under Medicare (Benefits Beyond Medicare), such as prescription drugs and vision and hearing services.

You can print a copy of the booklet for your records. To verify what plan you're in, check your ID card, ask your Personnel Office, or call Blue Cross Customer Service at (877) 737-7776.

2009 - 2010 Evidence of Coverage Booklets

• 2009 PERS Choice Basic Health Plan Evidence of Coverage (PDF, 1.2 MB)
• 2009 PERS Choice Supplement to Medicare Health Plan Evidence of Coverage (PDF, 714 KB)
• 2010 PERS Choice Basic Health Plan Evidence of Coverage (PDF, 1.64 MB)
• 2010 PERS Choice Supplement to Medicare Health Plan Evidence of Coverage (PDF, 1.31 MB)

Dated: 10-13-2009