UC Blue & Gold HMO

What You Need to Know

All six world-class UC medical groups and health centers are included in the UC Blue & Gold HMO network. As a member of the plan, you can select a UC provider as your Primary Care Physician (PCP) if one is located near where you live or work. Selecting a UC provider as your PCP also gives you access to world-renowned specialists within the same UC medical group. Members also have access to non-UC providers throughout the state.


The UC Blue & Gold HMO does not cover services outside California, except for urgent or emergency care.

Have Questions or Need Help?

Call Health Benefit Navigators at (800) 539-4072, Monday through Friday, 8 a.m. to 8 p.m. PT.

How It Works

See the summary of benefits and coverage [PDF] for more coverage details.

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No-Cost Preventive Care

Includes services such as screenings, immunizations and exams for you and all covered family members.

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What You Pay for Care


There is no deductible for covered services.


You pay a $20 copay for most office visits and other outpatient services.

Out-of-Pocket Maximum

This limits the amount you’ll pay for covered services during the year to a maximum of $1,000 (member) or $3,000 (family). After you meet the out-of-pocket maximum, Health Net pays 100% for most covered services, including prescription drugs, for the rest of the year.

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No Surprises

Did you know that if you receive emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing?

Learn more at healthnet.com.

Behavioral Health

Medically necessary mental health services and treatment for substance use disorder is administered by MHN Services. Visit the website or call MHN at (800) 663-9355, Monday through Friday, 8 a.m. to 8 p.m. PT.

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Prescription Drugs

  • Retail: $5 copay for generic; $25 copay for preferred brand; $40 copay for non-preferred brand; $20 copay for specialty and speciality self-injectible medications
  • Mail order: $10 copay for generic; $50 copay for preferred brand; $80 copay for non-preferred brand.

View details about in-network pharmacies, prescription drug coverage, and more on the Health Net website.

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Infertility Support

The journey to parenthood is not always easy. If you are struggling to conceive, Health Net is here to help. UC Blue & Gold HMO members are provided a 2-cycle lifetime maximum benefit toward IVF, GIFT and ZIFT treatment with 50% coinsurance, up to a combined limit of two treatment cycles per lifetime, per member. For more information, see the Family Planning and Maternity Guide [PDF] or call Health Net at Health Benefit Navigators at (800) 539-4072, Monday through Friday, 8:00 a.m. to 8:00 p.m. PT.

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Coverage for COVID-19 Testing

PCR testing is covered only when performed by Health Net providers and labs. Up to 8 over-the-counter tests are covered per month (when purchased through Health Net pharmacies), up to a $12 maximum per test.

Request reimbursement.

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Find Care

The UC Blue & Gold HMO gives you a range of options to get care when you need it—from in person to virtual care (telehealth), and urgent care and emergency services through University of California Health Providers, the Health Net provider network, and even retail clinics. (Your primary care doctor and specialists may also offer virtual appointment options. Contact their office for more information.) Find the right care for your need.

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Filing Claims

Except for emergencies, only services provided through Health Net and MHN network providers are covered. To file claims for out-of-network emergency care, contact Health Benefit Navigators at (800) 539-4072, Monday–Friday (8 a.m.–5 p.m. PT) or email askblue&gold@healthnet.com.

Get Help

For questions about coverage, claims, finding providers and more, call Health Benefit Navigators at (800) 539-4072 (Monday–Friday, 8 a.m.–8 p.m. PT) or visit the Health Net website or email your question.

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Health Net of California, Inc. is a subsidiary of Health Net, LLC. and Centene Corporation. Health Net, LLC. is a registered service mark of Health Net, LLC. Managed Health Network, LLC (MHN) is a subsidiary of Health Net, LLC and Centene Corporation. The MHN family of companies includes Managed Health Network and MHN Services, LLC. Managed Health Network is a registered service mark of Managed Health Network, LLC. All rights reserved.