Drug formulary, policy and forms
Search our drug formularies, find benefit and cost information for drugs, learn about our mail service pharmacy, view prior authorization procedures for drugs and find prior authorization forms.
Pharmacy claims processing
Effective January 1, 2021, Blue Shield of California pharmacy claims will be processed by CVS Health (CVSH). Please refer to the table below for bank identification number (BIN) and processor control number (PCN) information. For assistance with processing Blue Shield claims, please refer to the Pharmacy Help Desk telephone numbers.
| Plan type | BIN | PCN | CVSH Pharmacy Help Desk |
|---|---|---|---|
| Commercial | 004336 | 77993333 | (888) 970-0932 |
| Medicare | 004336 | 77993322 | (888) 970-0933 |
Pharmacy benefit design
Find details of the pharmacy benefit, including formulary, medication supply, injectable drug coverage and exclusions.
Pharmacy prior authorization procedures
Find an explanation of procedures for drugs requiring prior authorization and required forms.
Outpatient drug formulary
Access our online drug formularies and download printable versions.
Mail service pharmacy
Get information about CVS Caremark Mail Service, a full-service home delivery pharmacy providing Blue Shield of California members with mail service prescription services.
Generic drug policy
Read a description of Blue Shield of California policy regarding prescription of generic drugs and criteria they must meet to be included in the formulary.
Drug prior authorization forms
Download and print prior authorization forms for oral, topical and home self-administered injectable prescription drugs.
Medication policy
Read about our medication policy for injectable and office-administered drugs.
Online pharmacy authorization request
Submit your pharmacy authorization request for Blue Shield IFP, Small, Large Group and Medicare member online via AuthAccel.