Select one of the plans below to find more information about drug coverage under your benefits. Refer to the Drug Formulary for a list of Blue Shield preferred generic and brand-name medications which serves as a guide for our members in the selection of cost-effective drug therapy. Additional drug lists are also available.
Medicare Part D
Click the link below to learn about Medicare Part D prescription drug benefits and which drugs are covered in our plans.
Individual & Family Plan and Small Groups (1-100 Employees) including Covered California*
Click the links below to learn about different drug coverage topics on the Standard Drug Formulary for members in individual & family plans (IFP) or small group plans that have renewed their benefit. These prescription drug benefits can be obtained from Covered California or directly from Blue Shield of California.
2015 Standard Drug Formulary (Effective through 12/31/2015)
2016 Standard Drug Formulary (Effective 1/1/2016)
* Note: For members in grandfathered Individual & Family Plans, refer to the Plus Drug Formulary
Refer to this Specialty Drug list for specialty drugs that are obtainable only through a Blue Shield Network Specialty Pharmacy.
Refer to this Preventive Drug list to see drugs for which Health Reform requires coverage at $0 member share-of-cost.
Refer to this Contraceptive Drugs list to see drugs and devices covered at $0 member share-of-cost.
For non-grandfathered PPO and EPO plans, refer to this Vaccines list for covered vaccines, and for pharmacies available for vaccine administration.
return to top
Large Groups (100+ Employees)*
Learn about different drug coverage topics on the Plus Drug Formulary for members in large group plans.
* Note: For members in the 51-100 Small Business Transition plans or Simplified Plans, refer to the Standard Drug Formulary
. (PDF, 2.47MB)
Refer to this Specialty Drug list to view drugs that are obtainable only through a Blue Shield Network Specialty Pharmacy.
For members with a mandatory mail service or maintenance drug benefit, refer to this Maintenance list for drugs you may fill at the mail service pharmacy. Blue Shield's mail service pharmacy may provide other maintenance drugs.
Refer to this Preventive Health list to see drugs that Health Reform requires to be covered at $0 member share-of-cost.
Refer to this Contraceptive Drugs list to view drugs and devices covered at $0 member share-of-cost.
For select Blue Shield plans with the Value-Based Tier Drug benefit (VBTD), refer to this VBTD list for drugs that are covered at no charge, or at an otherwise reduced cost-share. Refer to your Evidence of Coverage or Certificate of Insurance to determine if you have a Value-Based Tier Drug benefit.
For non-grandfathered PPO and EPO plans, refer to this Vaccine list for covered vaccines and to locate pharmacies available for vaccine administration.
return to top