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MEDICARE

Prescription Drug Plan documents

All of your Blue Shield of California Medicare Prescription Drug Plan documents, including the enrollment form, enrollment checklist, multi-language notice and Medicare Star ratings documents, are listed on this page.

Plan documents can help you understand your plan.

Evidence of Coverage (EOC) describes in detail the health care benefits your plan covers.

Summary of Benefits (SOB) is a simplified document that summarizes your health benefits and coverage.

Annual Notice of Changes (ANOC) is a summary of any changes in the costs and coverage of your plan, effective each January 1.

You can also log into your online account and visit the Benefits section on your member dashboard.

If you want help understanding your documents, please call Blue Shield of California Medicare Prescription Drug Plan Customer Care at (888) 239-6469 [TTY: 711], 8 a.m. to 8 p.m., seven days a week.

Medicare Prescription Drug Plans (PDP)

Multi-language and nondiscrimination notices, and Star ratings

  • Multi-language and Nondiscrimination Notices

    Multi-language notice, English (PDF, 494 MB)
    Nondiscrimination notice, English (PDF, 584 KB) / Español (PDF, 44 KB)

  • Blue Shield Star ratings

    Blue Shield PDP Medicare Star Ratings*: English (PDF, 136 KB) / Español (PDF, 171 KB)

    *Every year, Medicare evaluates plans based on a 5-star rating system.

Please refer to our list of compatible browsers when downloading or viewing PDF documents.

Y0118_22_335A2_M Accepted 10092022
Page last updated: 10/14/2022

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