Blue Shield offers
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 healthcare benefits your plan covers.
Summary of Benefits (SOB) is a simplified document that outlines 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 every January 1.
For information on members and Blue Shield of California’s rights and responsibilities upon disenrollment, please refer to Chapter 8 in your EOC linked below.
Medicare Prescription Drug Plans (PDP)
Blue Shield Rx Plus (PDP)
Blue Shield Rx Enhanced (PDP)
Multi-language and Nondiscrimination Notices, and Blue Shield PDP Star ratings
Multi-language and Nondiscrimination Notices
Please refer to our list of compatible browsers when downloading or viewing PDF documents.
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 Service at (888) 239-6469 (TTY: 711), 8 a.m. to 8 p.m., seven days a week.
Y0118_23_408A1_M Accepted 10252023
H2819_23_408A1_M Accepted 10252023
Page last updated: 10/31/2023