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Prescription drug benefit information

Learn more about your Blue Shield Promise Cal MediConnect Plan pharmacy benefits and how to use them.

Steps to getting started

Get a prescription

Before you go to a pharmacy, you will need to get your prescription from your doctor or transfer your existing prescriptions to a pharmacy of your choice. Please refer to your plan formulary, which explains which drugs are covered, so you can discuss medication options with your doctor.

Get an extended-day supply

Your Blue Shield Promise Cal-MediConnect plan covers a 100-day supply of Tier 1 maintenance medications and 90-day supply of your Tier 2 through 3 maintenance medications at all network pharmacies (including CVS Caremark, our mail service pharmacy). Maintenance drugs are those prescribed to treat a chronic or long-term medical condition, such as asthma, diabetes, high blood pressure, or high cholesterol, and are taken on an ongoing, regular basis to maintain health. Ask your doctor for a 100 or 90-day supply prescription.

Note: Opioids and non-Part D drugs are only available with a 30-day supply.

Fill your prescription

You have the choice of filling your prescriptions at a network retail pharmacy or through our mail service pharmacy.

Using a network retail pharmacy

The Blue Shield Promise pharmacy network includes chain pharmacies along with other local community pharmacies. Search for a pharmacy in your area using the pharmacy locator or download the most current pharmacy directory.

Using our network mail service pharmacy

Have your maintenance medications delivered to your home or office through CVS Caremark with no charge for shipping or delivery. Log into your Blue Shield of California member account to create your mail service account at

Learn how to sign up for the program, place orders, and set up auto-refills:
How to use the mail service pharmacy, English (PDF, 121KB)
How to use the mail service pharmacy, Spanish (PDF, 120 KB)

Download our mail service pharmacy order form in your preferred language:
CVS Mail Service order form, English (PDF, 1.5MB)
CVS Mail Service order form, Spanish (PDF, 1.1MB)

To sign up, or if you have any questions, contact CVS Caremark  at: 
Phone: (866) 346-7200 [TTY: 711]

Using our network specialty pharmacies

All our network specialty pharmacies are available to all Blue Shield Promise Cal MediConnect members. Your physician may call or fax your prescription to any specialty pharmacy in our network, including CVS Specialty pharmacy.

Phone: (800) 237-2767 [TTY: 711], 4:30 a.m. to 6 p.m., Monday through Friday.
Fax: (800) 323-2445

Formulary: drugs in the plan

Use our online formulary search tool to access information on drugs covered by your plan or request a printed copy of the covered drugs list.

Access formulary information

Search 2022 List of Covered Drugs (Drug Formulary)

Find a pharmacy

Download our provider and pharmacy directory for your plan or search online.

Find a pharmacy near you

Get your plan's provider and pharmacy directory

Mail service pharmacy

Have your maintenance medications delivered to your home or office through CVS Caremark with no charge for shipping or delivery.

Use our mail service pharmacy

Coverage determinations: exceptions and prior authorizations

If you need a prescription medication that is not in our formulary, we may be able to make an exception and cover the drug. Also, some drugs on our formulary may require prior approval before we can cover it. Find more information on coverage determinations using the below link.

Get information and forms

Medication transition information

Find out what can you do if your medication is not in our formulary or is restricted.

Learn about medication transition process and policies

Medication therapy management

We offer a no-cost medication therapy management program to qualified members who are at a high risk for medication-related problems.

Learn about medication therapy management program

Utilization management program and quality assurance policies

Our utilization management program encourages appropriate, cost-effective use of Part D medications. To ensure that our members get safe, appropriate care, we have established quality assurance policies and drug utilization reviews.

Learn how we manage Part D drugs utilization

Read our quality assurance policies

Prescription drug reimbursement form

If you paid for a prescription drug out-of-pocket at a non-participating pharmacy, use the Direct Member Reimbursement (DMR) form to submit a claim to be reimbursed.

Download Cal MediConnect Part D Prescription Drug Reimbursement Form, English (PDF, 181KB)

Download Cal MediConnect Part D Prescription Drug Reimbursement Form, Spanish (PDF, 146KB)

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.

View OTC benefits catalog

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Page last updated: 10/1/2021

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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.