The application of each Blue Shield of California medical policy is subject to regulatory requirements and/or plan specific benefits and limitations (Evidence of Coverage - EOC).

Goals of medical policy include:

  • Ensuring safe and effective technologies
  • Supporting an evidence-based approach to technology
  • Providing current and pertinent information regarding technologies (devices, procedures for medical and behavioral health)
  • Improving the quality of care and services provided through Blue Shield

Use medical policy information to provide Blue Shield members with the highest standard of evidence-based medical care that is safe and effective.

Medical Benefit Drug Policy

View medical benefit drug policy in our Medication Policy section:

 Medication Policy

Medical policy index

Use this alphabetical index to find Blue Shield medical policies, and review requirements and criteria for new technologies, devices and procedures. The policies are updated frequently - see latest updates.

Find a medical policy for your patients who are out-of-area Blue plan members

Preventive Health Guidelines (PDF, 148KB)

Medical policy list