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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.

Prior authorizations and exceptions

Find the instructions, contact information, and physician forms you need to request prior authorizations and exceptions.

Find prior authorizations information

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. These decisions also impact how much a member has to pay for covered items or services.

Review our organization determination process

Nurse Advice Line

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. Available 24/7 for free.

Connect with a nurse

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 In-Home Supportive Services (IHSS), Community Based Adult Services (CBAS), and more.

Learn more about LTSS

Durable medical equipment

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

Learn about DME

Over-the-counter allowance and benefit catalog

As a Blue Shield Promise Cal MediConnect Plan member, you have an Over-the-counter (OTC) benefit, which allows you to purchase everyday health and wellness items.

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

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

Looking for 2019 Blue Shield Promise Cal MediConnect plan information?

If you're looking for the current year plan information, please visit the 2019 plans website.

View 2019 plan information

H0148_20_215 Accepted 10012019

Page last updated: 9/30/2019

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Blue Shield of California Promise Health Plan has neither reviewed nor endorsed this information.

Blue Shield of California Promise Health Plan is an independent licensee of the Blue Shield Association. Blue Shield of California Promise Health Plan is a Medicare Advantage HMO plan with a Federal Government contract in California. Enrollment in Blue Shield of California Promise Health Plan depends on contract renewal.

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