Dedicated Customer Service

Blue Shield provides one easy-to-use Customer Service phone number for both your medical and pharmacy benefits. You can contact them at (888) 499-5532 (TTY:711),
5 a.m. to 8 p.m. PT, Monday through Friday.

Find a doctor or specialist

Prior to your plan becoming effective, you can search for a PCP. Visit provider.bcbs.com to search for a PCP in the national BCBS PPO network and to view the latest listing of in-network providers, specialists, mental health providers and more. When asked for a prefix, enter “SFG”.

You can also contact Customer Service to help you find doctors near you at (888) 499-5532 (TTY:711), 5 a.m. to 8 p.m. PT, Monday through Friday.

If your local doctors tell you that they do not accept Blue Shield of California because you are located outside of California, please call Customer Service and share your doctor’s information. They can reach out to your doctor to explain how the Blue Shield PPO plan works outside of California.

Get started with your pharmacy benefits

Below is helpful information to help you with your pharmacy benefits, including how to check the Blue Shield Drug Formulary for your medications and how to enroll in our prescriptions-by-mail program once your plan becomes effective.

• Check the Blue Shield Drug Formulary - If you are currently taking a medication, you should check the Blue Shield Drug Formulary to see if your medication is in our list of preferred prescription drugs.

• Fill your current prescription(s) - Before transitioning to Blue Shield on January 1, 2027, work with your current provider to fill your current prescriptions.

• Prescriptions through network retail pharmacies - With Blue Shield you have convenient access to an extensive pharmacy network, including Safeway/Vons, Costco, CVS (including CVS Pharmacy in Target stores). To see if your preferred pharmacy is in the Blue Shield network, use our Pharmacy Locator. Once you become a member, you can fill your prescription by presenting your Blue Shield ID card at in-network pharmacies.

• Prescriptions by mail - After January 1, 2027, if you take stabilized doses of covered long-term maintenance medications for conditions such as diabetes, you can order a mail-service refill of up to a 90-day supply through Amazon Pharmacy. You may save money on your copayments, and there is no charge for shipping.

Request prior authorization for any scheduled treatments

If you have a condition and have been scheduled for treatment that required authorization from your former health plan carrier, it is likely that this treatment will now need to be authorized by Blue Shield. For questions about prior authorization or to initiate authorization contact Customer Service.

You can also download and print the most commonly requested prior authorization fax forms for procedures, physician administered drugs and pharmacy outpatient drugs here.

Get 24/7 access to your health plan information

After your plan becomes effective on January 1, 2027, register for your Blue Shield online account. Registration allows members to quickly find doctors, view claims, and more. To get started, you’ll need either your:

• Member ID
• Social security number (SSN)

To get started click, here.

Once you create your account you can manage your health care from anywhere with our Blue Shield of California App. View your ID card, search for doctors, track your claim information, understand your benefits, and more. The Blue Shield app provides BSC members enhanced 24/7 service and ease-of-access to the information that matters most.

Use the same login to manage your health care from anywhere with the Blue Shield mobile app – available to download on the App Store® or Google Play™.

Transferring your medical records

Once you have selected a new provider, they may request a copy of your prior medical records. Check with your current provider on how to get a copy of your records.

How to request Continuity of Care

Blue Shield’s Continuity of Care program helps eligible members remain under the care of your current provider when a network change occurs.

Examples of conditions that may qualify for continuity of care include:

• An acute condition that has a limited duration
• A serious, chronic condition
• Pregnancy, including the immediate postpartum period
• Care for a child, from newborn to 36 months of age
• A surgery or other treatment that was previously recommended and documented by your doctor to take place within 180 days of the effective date of coverage
• A terminal illness that has a high probability of causing death within one year or less, which is covered for the duration of the terminal illness

The program allows members to complete their care with your current healthcare provider in specific situations. To view the brochure and application for more information about the program and how to apply, visit here.

Look for your new member ID card

You should receive a new Blue Shield member ID card in the mail before your coverage becomes effective. Please review it carefully to make sure all the information is correct. You will use your new ID card whenever you get hospital and medical services covered by your plan, or prescription drugs at network pharmacies. We recommend you keep your Blue Shield ID card with you at all times.

As a PPO subscriber, you will receive one set of two ID cards with the main subscriber’s name listed. You will not receive individual ID cards for dependents.

View your Member health record

Once you become a member on January 1, 2027, you can access your health record. This shows your medical visits, medications, lab results, diagnoses, immunizations, claims and more in one secure place. You can also download and share this information with doctors and loved ones and view health reminders tailored to you. We provide near real-time updates to the health record.

Understand common terms related to your PPO plan costs

Here are some common terms to help you understand your PPO plan costs.

• Copay - A set dollar amount you may pay for some services, such as a doctor’s visit.

• Coinsurance - A percentage of the cost you may pay for a covered service. Unlike a copay, which is a set dollar amount, coinsurance is based on the allowable amount for a given service and may vary by service.

• Deductible - The amount you pay for most covered medical services before your health plan begins to pay. Some services, such as preventive care, are covered before you meet your calendar-year deductible.

For example, if you have a $250 deductible, you pay the first $250 of eligible medical costs before Blue Shield begins to share the cost.

• Allowable amount - The total dollar amount Blue Shield has established for a covered service. Doctors and other providers contracted with Blue Shield agree to accept this amount as payment in full. If you choose to see an out-of-network provider, you may be responsible for paying more.

• Balance billing - When an out-of-network provider charges you the difference between the provider’s billed amount and Blue Shield’s allowable amount. In addition to your deductible, copay, and coinsurance, you may pay this remaining balance, except in certain protected situations, such as emergency services.

Explore your new plan

To learn more about your new plan, visit blueshieldca.com/sfhss.

View your plan documents

To view your plan documents such as your Evidence of Coverage (EOC) or Summary of Benefits (SOB), click here.