Medical Benefits

Carrum Health is a surgery benefit that delivers an unparalleled experience.

• Concierge service from start to finish
• Surgery at zero cost to member (only HDHP deductible applies)
• Performed at high quality centers of excellence
• Companion goes with you and travel expenses are covered
• No bills!
• Eligible procedures include cardiac, shoulder, wrist/hand, elbow, ankle/foot, knee, hip, spine, and bariatric (weight loss)
   

If you need a surgery for total joint replacement, spinal fusion or bariatric you will be required to have a 2nd opinion consultation with Carrum Health.

If you have been told that one of the above surgeries are required, you have two options:

• Contact Carrum Health for a 2nd opinion consultation and continue the process to have the surgery through Carrum Health surgery program at no cost.

OR

• Contact Carrum Health for a 2nd opinion consultation, then have surgery in your local area with your Blue Shield provider.  Normal plan design co-payment/coinsurance will apply.
   

Call Carrum at 1.888.855.7806 or Text "EIA" to 555888 or visit carrum.me/eiahealth

Get Physical Therapy (And So Much More) Without The Hassle

The Santa Barbara Superior Court is excited to announce that PRISM Health and Carrum Health are partnering with Hinge Health to help you conquer back and joint pain, recover from injuries, or stay healthy and pain free. Best of all, Hinge Health's programs are provided at no cost to you and your eligible dependents, ages 18+ enrolled in a Court medical plan (Blue Shield EPO & HDHP plans).

Hinge Health provides all the tools you need to get moving again from the comfort of your home. Here are some of the ways your treatment plan could be tailored to you:

• Get a personal care team, including a physical therapist and health coach through the app, text, email, or virtual visits.
• Receive a free tablet and wearable sensors that give you live feedback during stretches and exercises.

• 15 minutes sessions on your phone or tablet can help you reduce pain and increase strength and flexibility.

Watch the Hinge Health video to learn more or visit hingehealth.com/prism and apply today!

Hinge Health and Prism Information

Questions or need help? Call (855) 902-2777.

Achieve your health goals with Wellvolution – Blue Shield's whole-health platform that's been designed with you in mind. 

Tap into decades of research and leading technology for a more productive and healthy lifestyle!

Our new Wellness program has been designed to custom fit your particular needs and lifestyle. A digital health platform and in person support network.

Wellvolution incorporates the following:

Prevent disease and reverse existing conditions – cardiovascular disease reversal, diabetes prevention, 12-week integrated nutrition and movement programs: BlueStar, MySugr, Tranform
Manage stress better – physiological, psychosocial and emotional training exercises, cognitive behavioral therapy: eM Life, Calm, SuperBetter
Sleep better – pattern tracking optimization, relaxation exercises: Sleep Time, Pacifica
Physical activity – movement tracking, guided good-based exercise plans, workout routines, coaching:  Fitbit, Fitocracy
Eat better – grocery and meal planning, nutritional calculators: Betr, Health Slate, PlateJoy, Zipongo
Ditch cigarettes – smoking cessation qualified by financial and lifestyle gains, nicotine replacement therapy:   Clickotine, SmokeFree, 2Morow Health

Stay on track and progress along the proven path. Receive digital reminders, motivation and engagement. All backed by real science for real, positive changes

24/7 Access to Doctors and Pediatricians

Teladoc provides you with access to board-certified doctors and pediatricians who are always available to resolve many of your medical issues via phone or online video consultations.  It's quality healthcare, when and where you need it.
Call Teladoc from anywhere - home, work, or on the road – and let the doctor come to you!  Teladoc doctors diagnosis and treat many of your non-emergency medical problems.  They can even write a prescription, if necessary, for you to pick up at your local pharmacy.

Teladoc doctors are available 24/7/365 to treat many of medical conditions, including: cold & flu symptoms; respiratory infection; ear infection; urinary tract infection; allergies; and, more!

Teladoc costs significantly less than urgent care and emergency room visits.  Plus, you can use Teladoc from the convenience of home or work, allowing you to avoid the hassle of sitting in a waiting room. All doctors are board-certified and licensed in your state.  You can count on Teladoc whenever your doctor is unavailable.

Visit www.teladoc.com/bsc for more information.

Under the EPO plan, the network of contracted physicians and hospitals are known as Preferred Providers. Under an EPO plan, you do not have an assigned Primary Care Physician (PCP). You are allowed to access medical services from any Blue Shield national contracted in-network PPO physician, specialist or facility without having to obtain a referral. All covered services, except for Emergency Care, must be provided by a Preferred Provider. The EPO plan does not provide out-of-network benefits.

• EPO Benefit Summary
• EPO Benefit Booklet
• www.blueshieldca.com/prism

The HDHP provides choice and two levels of service; in-network and out-of-network. The HDHP uses the Blue Shield national PPO networks so you have a choice of using in-network preferred providers or any out-of-network physician that you choose. There are no copayments; only co-insurance with coverage for in-network providers at a higher benefit level and lower cost to you. This plan has an annual deductible that must be met before it begins to pay the appropriate co-insurance amount.

A (Health Savings Account (HSA) is available to you if you are enrolled in a HDHP. An HSA account allows you to contribute using pre-tax dollars, funds roll over and accumulate year to year if not spent. HSA funds can be used to pay any qualified medical expenses. This type of health savings account is owned by you and is portable. If you decide to terminate the HDHP, you will no longer be able to deposit new funds into the HSA account, but funds already in the HSA will remain available for your use.

• HDHP Benefit Summary
• HDHP Benefit Booklet
• HDHP and HSA Basics Video
• www.blueshieldca.com/prism

A Health Saving Account (HSA) is available only to employees who participate in the Blue Shield High Deductible Health Plan (HDHP). A HSA is like a IRA for healthcare. It is a tax-advantaged personal savings or investment account that you can use to save and pay for qualified health expenses, now or in the future. Paired with a qualified high deductible health plan (HDHP), an HSA is a powerful financial tool that empowers you to be more actively
involved in your healthcare decisions.

An HSA allows you to:

• Save toward medical expenses (including dental and vision), up to IRS maximums (see Table)
• Have your contributions deducted on a pre-tax basis
• Change your contribution amount at any time
• Roll the funds to the following year (this is not a "use it or lose it" plan)
• Keep the account; it is portable; it goes with you if you leave employment
• Use a debit card to pay for qualified medical expenses
• Use the funds to pay for IRS tax dependents even if they are not enrolled in the HDHP

*These amounts are the maximum the IRS allows you to contribute to your HSA. If the Court contributes $900 into this account you have to deduct that amount from this limit   As an example: $4,150 - $900 =$3,250 would be the annual single contribution maximum you can make on a pre-tax basis in 2024.

Important Information:

• If you have a Healthcare Flex Spending Account (FSA) for 2023, you cannot open an HSA until the available funds in your 2023 FSA Healthcare account has been used, and the balance in your Healthcare FSA account is $0.
• You cannot have an HSA and be a dependent on another person's health insurance plan, unless that plan is also a High Deductible Health Plan.
• The Court will contribute $900 annually over 24 pay periods into your Sterling HSA account.

You must open your HSA with Sterling HSA. If you do not open your account you will not be able to receive any of the Court's contributions. 

• http://www.sterlinghsa.com/
• HSA Information
• HSA Enrollment Packet
• HSA: How They Work
• HSA Store
• HSA, HRA, FSA Sample Eligible Expenses
• HSA Tax Savings and Investment Options

Prescription drug coverage provides a benefit that is important to your overall health, whether you need a prescription for a short-term health issue like bronchitis or an ongoing condition like high blood pressure. If you enroll in medical coverage, you will automatically receive coverage for prescription drugs. Here are the prescription drug plans that are offered with our Blue Shield EPO and HDHP plans.

BLUE SHIELD EPO: Express Scripts is your pharmacy carrier if you are on the Blue Shield EPO plan. You have a separate pharmacy ID card for your prescription coverage. You must use this ID card to obtain your prescriptions from your local pharmacy. Your Blue Shield ID card will not be valid.

BLUE SHIELD HDHP: You must use your Blue Shield ID card to obtain prescriptions (Express Scripts will not be your pharmacy carrier).

• Questions & Answers
• Getting Started with Home Delivery
• Get Vaccinated

What is the Smart90 program?

This program is available to Express Scripts members that are taking maintenance medication on a daily basis. Express Scripts now gives you a choice on where to dispense a three month supply of your maintenance drugs. You now have two convenient options through Smart90. You can:

1. Fill your prescription through home delivery from the Express Scripts Pharmacy OR
2. Fill your prescription at any CVS or Wallgreens pharmacy

Relax with 90-day supplies

Here is how your prescription plan works:

1. If you are prescribed a daily maintenance medication, you have two 30-day fills at your local pharmacy.
2. After two refills, you must move to a 90-day supply through Express Scripts home delivery pharmacy or at your local CVS or Walgreens.
3. Let your doctor know that you need a 90-day supply when you are prescribed a daily maintenance medication. The doctor can write a prescription for 12 months and the medication can be refilled every 90 days.

Providing individuals access to pharmacy discounts since 2011

• Built by former Facebook, Yahoo, and health care execs
• Billions of prices for all FDA – approved drugs at retail pharmacy locations
• Search and compare prices
• Get free coupons
• Used and recommended by over 20% of health care providers

Visit Goodrx.com

Questions: 1.855.268.2822 (Monday-Sunday, between the hours of 8am and 7pm Central Time)

Blue Shield offers a free comprehensive 16-week program which helps qualified members lose weight, adopt healthy habits and significantly reduce their risk of developing type 2 diabetes.  The program meets weekly for 16 weeks and then monthly for the balance of the year.  You may choose from an array of national programs like Weight Watchers, Jenny Craig, Retrofit or HealthSlate. 

To find out if you qualify for this preventive program, go to www.solera4me.com/eia and take a one minute quiz.  If you qualify, use Blue Shield of CA as your health plan and your Blue Shield ID number to enroll.

Call Solera at 877.486.0141

Livongo for Diabetes makes diabetes management simple. This is a personalized experience to help members understand their blood sugar, develop healthy lifestyle habits, and improve glycemic control.

Click here for more information.

Physical Health

There are many online tools to make exercising at home, fun and effective.  Exercise is important for overall healthy well-being, but it is vital to protect yourself from airborne disease.  Try these free fitness activities from your home.  These are independent from medical carriers.

Yoga & Pilates
Corepower Yoga - Access free classes through their YouTube channel

Total Body
Active by POPSUGAR App - get hundreds of do-anywhere workouts
Les Mills - Les Mills on demand at home workouts

Running, Dance
Couch to 5k App - For those that want to improve on running
Fitness Marshall - Get ready to seat with Fitness Marshall
Rhythm and Motion – www.rhythmandmotion.com Free 1-hour dance workout videos for all levels
MadFit – Mad YouTube - Great at home workouts

Strength Training
BodyFit by Amy - BodyFit by Amy YouTube
8min buns – 8min Buns YouTube

Mental/Emotional Health

Without a doubt, many of us are feeling anxious as we navigate the uncertainty of COVID-19.  Here are some tools that you can use to take care of your mind and stay grounded.  No insurance required.

Meditation and Mindfulness
Insight Timer – The app features guided meditations, music and talks by contributing experts.  Basic service is free.

Simple Habit - A free medication app that offers short, meditation sessions designed to help busy people manage stress and live better.

Headspace - Train your mind and body for a healthier, happier life with this app.  Both a free (meditations, exercises) and buy-up option.

Resilience and Stress Management
Podcasts - The Happyness Lab, Ten Percent Happier with Dan Harris, Oprah's Super Soul conversations podcasts.  Inspiring stories, messages and research around happiness and daily tips to brighten one's outlook.

Playlists - Calm Vibes, Calming Acoustic, Calming Instrumental Covers, Peaceful Piano, Soothe, Calm Classic.  Music can have a profoundly relaxing effect on both minds and body.

Courses and Education

Wellness During Quarantine – Healbright.com  offers a free mental health course to address the stress caused by the COVID-19 pandemic.