CalPERS

Included Health can help you navigate your health plan.

We offer assistance with making sense of deductibles and out-of-pocket expenses. Our Care Coordinators also assist with requests for pre-authorization information, ensuring you understand all aspects of your coverage and can make informed decisions about your healthcare. You can access comprehensive plan coverage information. You can access comprehensive plan coverage information by logging in or calling 855-633-4436.

We are dedicated to helping you resolve issues related to your claims. We support you through denial of services, can help with pre-authorizations and can review any balanced billing statements. Log in or call 855-633-4436 to learn more and get started today.

We can help you understand the costs associated with receiving care. You can access estimates of out-of-pocket costs for common procedures with preferred providers or at recommended facilities, taking into account your specific coinsurance and deductibles, and any out-of-pocket maximums. Log in or call 855-633-4436 to learn more and get started today.

Access your historical medical and pharmaceutical claims, including claims for provider visits, through a convenient self-service app. You can view detailed information about each claim, including the claim type, facility, and your payment responsibility. Log in or call 855-633-4436 to learn more and get started today. 

If you are undergoing treatment for certain medical conditions and have been receiving care from a provider who is no longer in-network, you may qualify for continuity of care. Please contact us for more information.
 
Call 855-633-4436 to learn more.

You can dynamically track your spending progress towards medical deductibles and out-of-pocket maximums, helping you stay informed. Log in or call 855-633-4436 to learn more and get started today. 

The value-based site of care program is designed to help you save on out-of-pocket costs, other than your deductible and coinsurance. 

ASC Value-based Purchasing Flyer

Lab Services. Reduce your out-of-pocket costs by obtaining routine lab services at Labcorp or Quest Diagnostics. 

Laboratory Site of Care Flyer

Find a Quest near you.



Find a Labcorp near you.

For details regarding Lab Exceptions, please refer to your Evidence of Coverage (EOC) or contact Included Health at (855) 633-4436.

Outpatient Surgery. If you need a procedure, such as an arthroscopy (a surgical procedure to examine and treat a joint in an area like the knee) or a colonoscopy, you can save money by going to an ambulatory surgical center (ASC) instead of a hospital. By using an ASC that is part of the Value-based Site of Care program, you will have little to no out-of-pocket costs, other than the plan’s deductible and your coinsurance.

Other procedures that are part of the program include gallbladder removal, sigmoidoscopy (a test that examines your large intestine, similar to a colonoscopy), hernia repair, and nasal or sinus corrective surgery.

Hospital Outpatient Facility Form

Hip and Knee Joint Replacement Surgery. CalPERS and Blue Shield of California have enhanced the value-based pricing program for elective hip and knee replacement. As a result of breakthroughs in clinical care and technology, most joint replacement surgeries now occur on an outpatient basis. Outpatient surgery offers many advantages, including a shorter recovery time, less pain, and a lower risk of infection.

As a PPO member, you have the option to choose any facility. However, if you get care from one of the preferred participating facilities, you can lower your out-of-pocket costs. We can help you make sure a center or lab is part of the program. 

To learn more about ways to save money, log in or call Included Health at (855) 633-4436.

PPO Value-based Pricing Program for Hip and Knee Replacement Flyer