Blue Shield of CA PPO-20 for Medicare-Eligible Retirees Who Do Not Enroll in Medicare

What is Blue Shield of CA PPO-20?

When an SFHSS member or their dependent(s) does not enroll in Medicare Part A & B when eligible or who loses Medicare coverage due to non-payment of Medicare premiums, they will lose their existing SFHSS medical coverage and automatically be enrolled in Blue Shield of CA PPO-20. The Blue Shield of CA PPO-20 significantly increases premium and out-of-pocket costs.

Under Blue Shield of CA PPO-20, you will be responsible for paying the 80% that Medicare would have paid for a covered service, plus any amounts above usual and customary fees. In addition, under Blue Shield of CA PPO-20, yearly out-of-pocket limits increase to $10,950. 

Full SFHSS coverage for a member or dependent may be reinstated at the beginning of the next available coverage period after SFHSS receives proof of Medicare enrollment.