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Trio Plan

Trio is a comprehensive medical plan that covers only in-network providers and facilities within certain California counties, requiring you select a primary care doctor (PCP) who is responsible for the overall coordination of your care.

Trio uses a select Blue Shield of California network of doctors and hospitals (the Trio ACO HMO provider network). This network includes providers at UCSF, Dignity Health, Hills Physicians, and more. You pay a copayment at the point of service and the university covers the remaining costs. If you choose to see a doctor or use a hospital outside the network, you pay the full cost of the care you receive. Trio provides some benefits for students and family members living outside the service area through the Away From Home care program; availability varies by county and is not available in all states (read more here). 

Note: Trio is new for 2020.

Review 2020 plan information and Frequently Asked Questions about getting started with Trio.

 

Basics  

Overview

You must select a primary care physician (PCP) from the Trio network.

There is no benefit if you see a Non-Network provider, except for emergency or urgent care.

Pre-Authorization Requirement

Pre-authorization required for all hospital stays and outpatient procedures by your Medical group.

Office copays

$30 copay primary/$50 copay specialist

 

Deductible

No deductible

Out-of-Pocket Maximum

$3,500 per individual/$7,000 family

Combined Network or Non-Network. A single out-of-pocket maximum applies to all coverage under the plan, including medical and prescription drugs. (This will cover prescriptions and medical expenses at 100% once the out-of-pocket maximum is met.)

PREVENTATIVE CARE  

Physical exams for adults

100%

Physical exams for children

100%

Pap smears

100%

Immunizations

100%

Well-woman visits 100%
PRESCRIPTION DRUGS  

Pharmacy (Retail)

Up to a 30-day supply per prescription.

Contraceptive drugs and devices: $0

Tier 1 drugs: $10/prescription

Tier 2 drugs: $40/prescription

Tier 3 drugs: $100/prescription 

Tier 4 drugs (excluding specialty drugs): 20% up to $200/prescription

Mail order drug program

Up to a 90-day supply per prescription.

Contraceptive drugs and devices: $0

Tier 1 drugs: $20/prescription

Tier 2 drugs: $80/prescription

Tier 3 drugs: $200/prescription 

Tier 4 drugs (excluding specialty drugs): 20% up to $400/prescription

Specialty drugs and oral anti-cancer drugs: 20% up to $200/prescription (per prescription, up to a 30-day supply)

 

Birth Control Pills

Contraceptive drugs and devices: $0
 

Traveling Outside the U.S.

When you’re outside California or out of the country, you and your family can get urgent and emergency care through the BlueCard and Blue Shield Global Core programs. These programs offer access to doctors and hospitals almost everywhere in the U.S. and in 170 countries and territories around the world. To find a provider in the U.S., visit provider.bcbs.com, or call 800-810-BLUE. To find a provider outside the U.S., visit bcbsglobalcore.com, or call 804-673-1177 collect from outside the U.S.