Skip to main content
MENU
Medicare
Documents & Forms
Contacts & Mobile Apps
Close
Main navigation
UC Health Plans and Rx
Compare the Plans
UC Care
Health Savings Plan
CORE
UC Blue & Gold HMO
Other UC Medical Plans
Prescription Drugs
Filing Claims
Accolade Health Care Advocate
Find Care
Wellness Resources
Behavioral Health
Physical Health
Discounts
Transitioning to Medicare
Documents & Forms
Contacts & Mobile Apps
Search
Search
Documents & Forms
Breadcrumb
Home
Documents & Forms
Filter by health plan
Filter by health plan
All topics
PPO Plans: UC Care, Health Savings Plan, CORE
UC Blue & Gold HMO
UC Blue & Gold HMO
2023
Comprehensive and easy-to-use benefits available to University of California Health Net members
UC Blue and Gold 2023 Evidence of Coverage [PDF]
UC Blue and Gold 2023 Summary of Benefits & Coverage [PDF]
Forms
Health Net forms
PPO Plans: UC Care, Health Savings Plan, CORE
2023
Core 2023 Benefits Booklet [PDF]
CORE 2023 Medical Plan Benefits Summary [PDF]
Core 2023 Prescription Drug Plan Benefits Booklet [PDF]
CORE 2023 Summary of Benefits & Coverage [PDF]
Health Savings Plan 2023 Benefits Booklet [PDF]
Health Savings Plan 2023 Medical Plan Benefits Summary [PDF]
Health Savings Plan 2023 Prescription Drug Plan Benefits Booklet [PDF]
Health Savings Plan 2023 Summary of Benefits & Coverage [PDF]
Navitus 2023 Formulary [PDF]
UC Care 2023 Benefits Booklet [PDF]
UC Care 2023 Medical Plan Benefits Summary [PDF]
UC Care 2023 Prescription Drug Plan Benefits Booklet [PDF]
UC Care 2023 Summary of Benefits & Coverage [PDF]
2022
2022 Navitus Maintenance Drug Program and UC Medical Center Pharmacies [PDF]
2022 PPO Open Enrollment Guide [PDF]
CORE 2022 Benefits Booklet [PDF]
CORE 2022 Medical Benefits Summary—Spanish [PDF]
CORE 2022 Medical Plan Benefits Summary [PDF]
CORE 2022 Navitus Pharmacy Member Brochure [PDF]
CORE 2022 Prescription Drug Summary Plan Description [PDF]
CORE 2022 Summary of Benefits & Coverage—English [PDF]
CORE 2022 Summary of Benefits & Coverage—Spanish [PDF]
Health Savings Plan 2022 Benefits Booklet [PDF]
Health Savings Plan 2022 Medical Benefits Summary—Spanish [PDF]
Health Savings Plan 2022 Medical Plan Benefits Summary [PDF]
Health Savings Plan 2022 Navitus Pharmacy Member Brochure [PDF]
Health Savings Plan 2022 Prescription Drug Summary Plan Description [PDF]
Health Savings Plan 2022 Summary of Benefits & Coverage—English [PDF]
Health Savings Plan 2022 Summary of Benefits & Coverage—Spanish [PDF]
UC Care 2022 Benefits Booklet [PDF]
UC Care 2022 Medical Plan Benefits Summary [PDF]
UC Care 2022 Navitus Pharmacy Member Brochure [PDF]
UC Care 2022 Prescription Drug Summary Plan Description [PDF]
UC Care 2022 Summary of Benefits & Coverage—English [PDF]
UC Care 2022 Summary of Benefits & Coverage—Spanish [PDF]
PPO Plan Forms: UC Care, Health Savings Plan, CORE
Forms
Authorization of Release of Personal and Health Information [PDF]
International Medical Claim Form [PDF]
Medical Claim Form [PDF]
Prescription Drug Claim Form [PDF]