Provided By
RETA / Blue Cross Blue Shield of California
Provider Website
Customer Service
Medical Benefits
Your employer offers medical insurance to protect the health of you and your family. It covers medical expenses such as visits to the doctor’s office, emergency care, and prescription drugs. It’s important to have a medical plan that meets your needs.
Keep in mind that your out-of-pocket costs will be lower if you receive care from an in-network doctor and facility. To find an in-network doctor, please visit blueshieldca.com.
In-Network Only |
|
|---|---|
Deductible |
$500 / $1,000 |
Out-of-Pocket Max |
$2,000 / $4,000 |
Physician Visits |
|
Primary Care Office Visit |
$20 Copay, Deductible Waived |
Adult Routine Exams & Preventive Services |
No Charge, Deductible Waived |
Well Child Care (Birth to age 7) |
No Charge, Deductible Waived |
Specialist Office Visit |
$35 Copay, Deductible Waived |
Hospital Services |
|
Physician Services |
10% of Eligible Charge |
Inpatient Hospitalization |
10% of Eligible Charge |
Outpatient Surgery |
10% of Eligible Charge |
Basic Outpatient Diagnostics |
10% of Eligible Charge |
Emergency Health Coverage |
|
Emergency Room |
$100 Copay, then 10%, Deductible Waived |
Urgent Care |
$50 Copay |
Retail Prescriptions |
|
Tier 1 - Generic |
$10 Copay |
Tier 2 - Preferred Brand |
$20 Copay |
Tier 3 - Non-preferred Brand |
$40 Copay |
Mail Order Prescriptions |
|
Tier 1 - Generic |
$10 Copay |
Tier 2 - Preferred Brand |
$20 Copay |
Tier 3 - Non-preferred Brand |
$40 Copay |
*Disclaimer* Active priests 65+ are required to enroll in the Medicare and supplemental plans offered |
Copayment and/or coinsurance is determined by the tier to which the Prescription Drug List (PDL) Management Committee has assigned the Prescription Drug Product. All Prescription Drug Products on the CVS Caremark Preferred Rx List are assigned as one of the four tiers.
Find individualized information on your benefit coverage, determine tier status, check the status of claims and search for network pharmacies by logging on to www.caremark.com.
Medicare Part D
The prescription drug benefit is creditable coverage. Medicare eligible participants need not enroll in a separate Medicare Part D drug plan.
Rx Mail Order Program
Save time and money by filling maintenance drugs through the mail order program. The Mail Order Program benefits members who are on long-term medications for chronic conditions such as diabetes, high cholesterol, high blood pressure, depression or asthma. By utilizing the Mail Order Program, you can receive a 90-day supply of medication for the equivalent of two retail copayments. That’s a savings of one copayment for every 90-day supply.
We encourage you to visit www.blueshieldca.com for locating providers, reviewing covered prescriptions, monitoring the status of claims, and for viewing your Member ID Card.
1. Visit blueshieldca.com and click Find a Doctor in the top toolbar.
2. Enter the zip code of the location you would like to search, then select find out-of-state care.
3. Click Find Care and Continue.
4. Click Choose location and Plan, enter your zip code again and click Yes, this is correct.
5. Type the following 3 letters for the Plan Prefix: REA
6. Search by Doctor Name, Specialty or Facility.
Provided By
RETA / Blue Cross Blue Shield of California
Provider Website
Customer Service