Medi-Cal Pharmacy

The Department of Health Care Services (DHCS) will change your pharmacy benefit. Your prescription medications will be covered by Medi-Cal Rx.

Until then, you will continue to get your Medi-Cal-covered prescriptions through Blue Shield of California Promise Health Plan with no interruption of service.

The Department of Health Care Services (DHCS) announced that the start of Medi-Cal Rx has been delayed. Until then, your prescription drug coverage will not change. Managed care plans, like Blue Shield of California Promise Health Plan (Blue Shield Promise), will continue to provide pharmacy benefits to our Medi-Cal members.
 
There is no action for you to take. There is no change for you. Until Medi-Cal Rx starts, you will continue to receive pharmacy benefits from Blue Shield Promise. There will be no interruption of service. You can continue to take your current drug(s). You can continue to go to your local pharmacy.
 
This extended delay does not change your Medi-Cal eligibility, benefits, or enrollment with Blue Shield Promise.
 
Key things to remember:
  • Your Medi-Cal prescription benefits will continue to be covered by Blue Shield Promise with no interruption.
  • There is no change in your prescription coverage. You can continue to take your drug(s). You can go to your same local pharmacy.
  • Always have your Blue Shield Promise member ID card and your Medi-Cal Benefits Identification Card (BIC) with you.
 
If you have any questions about your pharmacy benefit, please call:
 
Los Angeles County:
(800) 605-2556 (TTY: 711), 8 a.m. to 6 p.m., Monday through Friday
 
San Diego County:
(855) 699-5557 (TTY: 711), 8 a.m. to 6 p.m., Monday through Friday
 

Frequently asked questions (FAQs):

  • Why was Medi-Cal Rx delayed?

    The extended delay of Medi-Cal Rx allows DHCS more time to make sure that they have everything in place to provide complete prescription drug services for Medi-Cal’s nearly 13 million members. This is especially needed during the ongoing uncertainties caused by the COVID-19 public health emergency (PHE). State-contracted pharmacies and other providers will have more time to take additional trainings, allowing them to become more familiar with the Medi-Cal Rx processes for submitting claims and prior authorizations, as well as other tasks within the Medi-Cal Rx provider portal.

  • How does this impact my pharmacy benefits?

    With the delay, this means that Blue Shield Promise will continue to provide you with your pharmacy benefits. There will be no interruption of service. You will continue to have coverage for your drug(s). You can keep going to your local pharmacy. Please continue to contact us for all your pharmacy benefit questions. This includes prior authorizations, complaints, appeals, and grievances.

  • I received a letter about Medi-Cal Rx starting on April 1, 2021. What do I need to do?

    You do not need to do anything. Blue Shield Promise will continue to provide you with your pharmacy benefits until then with no interruption of service.

  • How can I get a new Medi-Cal BIC?

    If you did not receive your BIC, or if it is lost or stolen, you may ask for a replacement from:

    Los Angeles County Department of Public Social Services Customer Service Center (866) 613-3777

    San Diego County Department of Health & Human Services Agency Customer Service Center (866) 262-9881

  • Whom do I call if I have a problem with my pharmacy benefits?

    For complaints, appeals, and grievances about your pharmacy benefits, please call us on the number on your card.

  • Does my doctor or pharmacy know about the extended delay of Medi-Cal Rx?

    Yes. We have informed providers and pharmacies about this change.

  • My pharmacy says they need “BIN” and “PCN” information to process my prescription?

    Pharmacies were provided with Bank Identification Number (BIN) and Process Control Number (PCN) to process your 2021 prescription claim. If your pharmacy does not have this information, below is the Blue Shield Promise Medi-Cal BIN and PCN information. They can also call the Pharmacy Help Desk for assistance.

    BIN: 004336
    PCN: 77993344
    Pharmacy Help Desk: (888) 970-0934

Blue Shield of California Promise Health Plan is an independent licensee of the Blue Shield Association.

Blue Shield of California Promise Health Plan is contracted with the Department of Health Care Services (DHCS) to provide managed care services in San Diego County. Blue Shield of California Promise Health Plan is contracted with L.A. Care Health Plan to provide Medi-Cal managed care services in Los Angeles County.

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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.

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