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Blue Shield Promise Cal MediConnect benefits information

Blue Shield Promise Cal MediConnect Plan (Medicare-Medicaid Plan) combines Medicare and Medi-Cal coverage into one plan to provide you all-in-one coverage. Read through the information below for a better understanding of your benefits through the Blue Shield Promise Cal MediConnect Plan.

Part D Coverage determinations

Coverage determinations are decisions that the Blue Shield Promise Cal MediConnect Plan makes about your coverage of prescription drugs.

Review our Part D coverage determination process

Organization determinations

Organization determinations are coverage decisions Blue Shield of California Promise Health Plan makes about whether items or services requested by a member or provider can be covered. 

Find prior authorization information

Review our organization determination process

Non-network coverage

As a Blue Shield Promise Cal Mediconnect plan member, you must use network providers to get your medical care and services. However, in some cases, Blue Shield of California Promise Health Plan may authorize use of non-network providers. See which services may be covered.

Learn about non-network medical and prescription drug coverage

Get reimbursement information for emergency services received outside the country

Behavioral health services

Learn about behavioral healthcare services (mental health and substance use disorders) covered by your plan, such as treatment for anxiety, depression, or other behavioral health problems.

Learn about behavioral health services

Long-Term Services and Support

Blue Shield Promise Cal MediConnect Plan's Long-Term Services and Support (LTSS) covers such benefits as Community- Based Adult Services (CBAS), and Long-Term Care.

Learn more about LTSS

Durable medical equipment

Learn what durable medical equipment (DME) is and what your medical plan covers.

Learn about DME

Personal Emergency Response System (PERS)

To keep you safe and independent, we offer a medical alert monitoring system from LifeStation that provides access to help 24/7 at the push of a button. 

Learn about Personal Emergency Response System (PERS)

Home meal delivery

If you’re recovering from a stay in the hospital or a skilled facility, we offer a home meal delivery service.

Learn about home meal delivery

Over-the-counter allowance and benefit catalog

Access your Over-the-counter (OTC) benefit and learn how you can purchase every day health and wellness items.

Learn about OTC

View OTC benefits catalog

SilverSneakers, a free gym membership program

Learn about SilverSneakersTM, a valuable program which Blue Shield of California Promise Health Plan provides at no extra cost.

Learn about SilverSneakers

Virtual consultations

Connect with a qualified English- or Spanish-speaking registered nurse who will listen to your health problem description, and advise whether you need to see a doctor. Free, and available 24/7. Or talk to a physician through Teladoc. 

Connect with a nurse

Learn about Teladoc

Prescription drug benefit information

Access and search your plan formulary - the list of drugs covered by your plan. Get pharmacy directories and learn about specialty pharmacies in our network and our mail service pharmacy. Review medication related policies.

Learn about the prescription drug benefits

Find a pharmacy

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Page last updated: 10/01/2021

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Medicare has neither reviewed nor endorsed this information. Blue Shield of California Promise Health Plan is a health plan that contracts with both Medicare and Medi-Cal to provide benefits of both programs to enrollees.