Help PDP clients

Here are PDF resources that can help you manage your existing Blue Shield of California PDP clients in our plans for Medicare beneficiaries.


  • Evidence of Coverage documents
  • Star ratings
  • Pharmacy directories
  • Formularies
  • Change of plan and disenrollment forms


Please note:
All materials you need for enrollment are located on the Arvato Storefront.


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2024 Evidence of Coverage

2024 Blue Shield Rx Plus English (PDF, 2.5 MB)
Spanish (PDF, 654 KB)
2024 Blue Shield Rx Enhanced English (PDF, 2.7 MB)
Spanish (PDF, 655 KB)

2024 Star ratings

Blue Shield PDP Medicare Star ratings* English (PDF, 164 KB)
Spanish (PDF, 142 KB)

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

2024 Pharmacy directories

2024 Blue Shield Medicare Prescription Drug Plans (PDP) English (PDF, 3 MB)
Spanish (PDF, 2.9 MB)

2024 Formularies

2024 Change of plan and disenrollment forms

PDP Change of plan form English (PDF, 109 KB)
Spanish (PDF, 100 KB)
PDP disenrollment form English (PDF, 58 KB)
Spanish (PDF, 60 KB)

The company complies with applicable state laws and federal civil rights laws and does not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, ethnic group identification, medical condition, genetic information, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, mental disability, or physical disability. La compañía cumple con las leyes de derechos civiles federales y estatales aplicables, y no discrimina, ni excluye ni trata de manera diferente a las personas por su raza, color, país de origen, identificación con determinado grupo étnico, condición médica, información genética, ascendencia, religión, sexo, estado civil, género, identidad de género, orientación sexual, edad, ni discapacidad física ni mental. 本公司遵守適用的州法律和聯邦民權法律,並且不會以種族、膚色、原國籍、族群認同、醫療狀況、遺傳資訊、血統、宗教、性別、婚姻狀況、性別認同、性取向、年齡、精神殘疾或身體殘疾而進行歧視、排斥或區別對待他人。

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Page last updated: 1/1/2024

© California Physicians' Service DBA Blue Shield of California 1999-2024. All rights reserved. California Physicians’ Service DBA Blue Shield of California is an independent member of the Blue Shield Association. Health insurance products are offered by Blue Shield of California Life & Health Insurance Company. Health plans are offered by Blue Shield of California.