MEDI-CAL RX

Since January 1, 2022, the Department of Health Care Services (DHCS) manages your pharmacy benefit through the state-run program called Medi-Cal Rx.

This means that you get most of your Medi-Cal-covered prescriptions through Medi-Cal Rx when you get them from a pharmacy.

 

Medi-Cal Benefits Identification Card (BIC)

You need to show your Medi-Cal Benefits Identification Card (BIC) when you go to the pharmacy. The pharmacy may use your BIC to look up your information and give you your medications.

Medi-Cal State of California, Benefits Identification Card with ID No. 01234567A96144, JOHN Q RECEPIENT, M 05 20 1991, Issue Date 05 24 16, front side
Benefits Identification Card sample, front

Medi-Cal State of California, Benefits Identification Card with ID No. 90000000A95001, SUE G RECEPIENT, F 05 20 1993, Issue Date 01 01 05, back side
Benefits Identification Card sample, back

Blue Shield Promise member ID card

You will need to show your Blue Shield Promise member ID card when you go to your doctor or hospital.
Always carry both your Blue Shield Promise ID member card and your BIC with you.

Blue Shield Promise Health Plan, Los Angeles County member ID card sample, with member name, member ID and effective date, front side
Los Angeles County member ID card sample, front

 

Blue Shield Promise Health Plan, Los Angeles County member ID card sample, with phone numbers, back side
Los Angeles County member ID card sample, back

 

Blue Shield Promise Health Plan, San Diego County member ID card sample, with member name, member ID and effective date, front side
San Diego County member ID card sample, front

 

Blue Shield Promise Health Plan, San Diego County member ID card sample, with phone numbers, back side
San Diego County member ID card sample, back

 

Physician-administered drugs

Some drugs are covered by your Blue Shield of California Promise Health Plan (Blue Shield Promise) rather than Medi-Cal Rx. These are drugs given to you by a medical healthcare provider, like a doctor or nurse. They are called physician-administered drugs (PADs). PADs can be given to you at a doctor’s office or infusion center, or at home with a home infusion provider.

To learn more about PADs, see the Frequently asked questions (FAQs) below. You can also view this flyer: Blue Shield Promise PADs (PDF, 78 KB).

 

Need help with Medi-Cal Rx?

If you have questions about Medi-Cal Rx, call the Medi-Cal Rx Customer Care Center at (800) 977-2273, 24 hours a day, seven days a week. Use 711 for TTY, 8 a.m. to 5 p.m., Monday through Friday. They can also help you with pharmacy complaints, appeals, and grievances.

 

Frequently asked questions (FAQs):

You need to show your Medi-Cal BIC when you go to the pharmacy. The pharmacy may use your BIC to look up your information and give you your medications.


 

If you do not have a 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


 

You can use the Find a Medi-Cal Rx Pharmacy Locator tool at Medi-CalRx.dhcs.ca.gov.

You can also call Medi-Cal Rx Customer Service Center (CSC) at (800) 977-2273, 24 hours a day, seven days a week. Use 711 for TTY, 8 a.m. to 5 p.m., Monday through Friday.


 

For complaints, appeals, and grievances about your pharmacy benefits, please call:

Medi-Cal Rx Customer Service Center at (800) 977-2273, 24 hours a day, seven days a week. Use 711 for TTY, 8 a.m. to 5 p.m., Monday through Friday.


 

Yes, you can. Do NOT include personal information in your first email. Tell them you are writing about Medi-Cal Rx. DHCS staff will reply from a secure email address. If they need your personal information, they will ask for it then.

Email your questions, complaints, appeals, and grievances to DHCS at RxCarveOut@dhcs.ca.gov.


 

Physician-administered drugs (or PADs) are drugs administered (given to you) by a medical healthcare provider, like a doctor or nurse. This may happen at a doctor’s office or infusion center, or at home with a home infusion provider.


 

Your physician-administered drugs (PADs) are covered by Blue Shield Promise. These drugs are not covered by your pharmacy benefit.


 

No, you do not have to do anything special to get your physician-administered drugs (PADs). Because PADs are given to you by your medical healthcare provider when needed, you do not have to go to a pharmacy or order these drugs by mail.


 

Yes. DHCS and Blue Shield Promise have informed providers about PADs and how they should bill for them.


 

Before you start getting physician-administered drugs, you may need permission from Blue Shield Promise. Your doctor will ask for you. This is called asking for prior authorization (or pre-approval). It is the way that Blue Shield Promise makes sure this care is medically necessary (or needed for you). You do not need to submit anything.


 

For more information, please visit:

 

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.

Last updated: Mar 20, 2023

Health Care Options: (844) 580-7272  {TTY: {800) 430-7077}, Monday through Friday from 8 a.m. — 6 p.m. 

For information on Blue Shield Promise plans for your health care, call the Department of Health Care Services at (800) 430-4263 {TTY: (800) 735-2922}, or visit https://www.healthcareoptions.dhcs.ca.gov/.

Blue Shield of California Promise Health Plan is a managed care organization, wholly owned by Blue Shield of California, offering Medi-Cal Plans.

© 2002-2024. California Physicians’ Service DBA Blue Shield of California Promise Health Plan. All rights reserved.

California Physicians’ Service DBA Blue Shield of California Promise Health Plan is an independent licensee of the Blue Shield Association.

The provider network may change at any time. You will receive notice when necessary.

Blue Shield of California Promise Health Plan complies with applicable state laws and federal civil rights laws, and does not discriminate on the basis of race, color, national origin, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, or disability.

Blue Shield of California Promise Health Plan cumple con las leyes estatales y las leyes federales de derechos civiles vigentes, y no discrimina por motivos de raza, color, país de origen, ascedencial, religión, sexo, estado civil, genero, identidad de genero, orientación sexual, edad ni discapacidad.

Blue Shield of California Promise Health Plan 遵循適用的州法律和聯邦公民權利法律,並且不以種族、膚色、原國籍、血統、宗教、性別、婚姻 狀況、性別認同、性取向、年齡或殘障為由而進行歧視。

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