Beginning January 2023, you will have access to a Price Transparency Tool, which you and your family members can use to:
• Compare personalized estimates for medical services or medication
• Calculate treatment to estimate your out-of-pocket costs
• Search for locations and network facility options
The Price Transparency Tool is part of the historic legislations known as the Consolidated Appropriations Act of 2021 (CAA) passed by Congress in 2021, which established protections for consumers related to surprise billing and transparency in health care.
Per CAA, the Price Transparency Tool is intended to support an efficient and competitive health care market by enabling consumers like you to evaluate health care options and to make cost-conscious decisions; by strengthening, supporting and protecting consumers; by reducing potential surprises to individual consumers’ out-of-pocket costs for health care services; by creating competition between providers who offer the same items and services in the same health care markets; and by putting downward pressure on prices, which, in turn, potentially may lower overall health care costs.
The Price Transparency tool, will be available starting on January 1, 2023.
BLUE SHIELD CALIFORNIA PPO MEMBERS: See blue button below. You will need to create a MedExpert login to access the tool. You can use any smartphone, tablet or computer/laptop. The tool is also available to you over the phone. If you do not have any electronic devices, or if you need any help using the online tool, call MedExpert at (800) 999-1999. A specialist will assist you every step of the way.
KAISER HMO MEMBERS: See green button below. You will need to log into your Kaiser account on kp.org
ELIXIR RX PRESCRIPTIONS: See purple button below. You will need to log into your Elixir Rx Prescriptions account on elixirsolutions.com