Select one of these plans to find more information about drug coverage under your benefits. Refer to the drug formulary for a list of Blue Shield preferred generic and brand-name medications. The Formulary is a guide that helps our members choose cost-effective drug therapy. Additional drug lists are also available.

 

Medicare Part D

Click the link to learn about Medicare Part D prescription drug benefits and which drugs are covered in our plans.

 

Individual and Family Plan and Small Groups (1-100 employees) including Covered California*

Click the links to learn about different drug coverage topics on the Standard Drug Formulary for members in Individual and Family Plans (IFP) or small group plans that have renewed their benefit. These prescription drug benefits can be obtained from Covered California or directly from Blue Shield of California.

2018 Standard drug formulary

*For members in grandfathered IFPs, refer to the Plus drug formulary (PDF, 4.42MB)

Refer to this specialty drug list for specialty drugs that are obtainable only through a Blue Shield Network Specialty Pharmacy.

Refer to this preventive drug list to see drugs for which health reform requires coverage at $0 member share of cost.

Refer to this contraceptive drugs list to see drugs and devices covered at $0 member share of cost.

For eligible non-grandfathered plans, refer to this vaccine list for covered vaccines and to locate pharmacies available for vaccine administration.

For Small Business Tandem Plans, refer to this condensed listing to see Level A pharmacies. A full listing of Level A pharmacies is available in the Pharmacy Directory below.

For Small Business Tandem Plans, refer to this pharmacy directory to see Level A pharmacies.

 

Large Groups (100+ employees)

Blue Shield of California offers two formularies, the Plus Drug Formulary and Value Drug Formulary for large group plans. Please refer to your Summary of Benefits plan documents to learn which formulary your plan uses.

Note: The Specialty, Maintenance, Preventive, Contraceptive, Value-Based Tier, and Vaccine drug lists listed below are not plan specific.

2018 Plus drug formulary

2019 Plus drug formulary

2019 Value drug formulary

 

Refer to this specialty drug list to view drugs that are obtainable only through a Blue Shield Network Specialty Pharmacy.

For members with a mandatory mail service or maintenance drug benefit, refer to this maintenance list for drugs you may fill at the mail service pharmacy. Blue Shield's mail service pharmacy may provide other maintenance drugs.  

Refer to this preventive drug list to see drugs that health reform requires to be covered at $0 member share of cost.

Refer to this contraceptive drug list to view drugs and devices covered at $0 member share of cost.

For select Blue Shield plans with the Value-Based Tier Drug (VBTD) benefit, refer to this list for drugs that are covered at no charge, or at an otherwise reduced cost-share. Refer to your Evidence of Coverage or Certificate of Insurance to determine if you have this benefit.

For eligible non-grandfathered plans, refer to this vaccine list for covered vaccines and to locate pharmacies available for vaccine administration.

For plans that have the Rx Spectrum rider, refer to this condensed listing to see Level A pharmacies. A full listing of Level A pharmacies is available in the Pharmacy Directory below.

For plans that have the Rx Spectrum rider, refer to this pharmacy directory to see Level A pharmacies.


If you are a Blue Shield member, you should check your Evidence of Coverage booklet/Certificate of Insurance/Policy to find out about drug coverage and how our formulary may apply to your specific plan.

Our formulary is updated quarterly by a group of community physicians and pharmacists and is subject to change. Please check back regularly for recent additions and deletions.