The Blue Shield of California formulary is developed and updated regularly by the Blue Shield Pharmacy and Therapeutics (P&T) Committee and meets all Medicare requirements for included and excluded drugs. The Blue Shield of California Formulary contains medications that have been reviewed and approved by the Food and Drug Administration (FDA).
The Blue Shield P&T Committee includes physicians and clinical pharmacists from our provider and pharmacy networks, and voting members are not employees of Blue Shield of California. To assist physicians in prescribing medically appropriate and cost-effective medications, the P&T Committee reviews medical literature, the FDA drug label, and national treatment guidelines to update the formulary and drug prior authorization criteria. All recommended changes to Blue Shield Medicare formularies and drug prior authorization criteria are first approved by the Centers for Medicare and Medicaid Services (CMS), which provides oversight of the Medicare program.
If your selected plan does not cover a specific drug, you can ask Blue Shield of California to make an exception to the rules that govern coverage. Visit Coverage determinations and exceptions page for more information
Formulary by plan
Select a plan below to see a list of drugs covered under that plan. Formularies are available online and in PDF format for download: you will need Adobe Reader to view the PDF.
Medicare Part B Diabetic Test Strips for Medicare Advantage - Prescription Drug Plans
Learn about Part B preferred diabetic test strips (PDF, 106KB).
Medicare Part B Diabetic Test Strips for Medicare Advantage - Prescription Drug Plans Group Plan Formulary
Learn about Part B preferred diabetic test strips (PDF, 106KB)
If you are enrolled in Blue Shield Medicare (PPO) plan, your Part B drugs may be subject to Step Therapy. View the Part B Step Therapy Criteria.(PDF, 54KB)