If your previous PCP is out-of-network (OON) for 2025 or does not meet Blue Shield’s PCP criteria, you may have been matched to a different PCP within the Blue Shield network. Blue Shield is continually adding new providers to its network and updating its PCP criteria. If you would like to change your PCP, please contact the Included Health care team or visit the Blue Shield member portal to search for available PCPs or to update your PCP.
For PPO plans, you can see any PCP without needing a referral even if they are not listed on your ID card. For Gold plan members, there is a copay incentive to see your designated PCP or a PCP at the same location. Platinum plan members do not have a copay difference between their designated PCP or another PCP of their choice.
If you need assistance navigating the portal, you can contact the Included Health care team for support by calling 855-633-4436 or by logging into your Included Health account to start a chat.