Plan documents

Health plan documents

Blue Shield Medicare (PPO) plan

Blue Shield Medicare (PPO) plan: January 1, 2027 - December 31, 2027

Summary of Benefits
Pharmacy directory
Evidence of Coverage (coming soon)
Diabetic Supplies (coming soon)
Formulary drug list (coming soon)
Provider directory (coming soon)

Blue Shield Medicare (PPO) plan: January 1, 2026 - December 31, 2026

Summary of Benefits
Evidence of Coverage
Diabetic Supplies
Provider directory
Formulary drug list
Pharmacy directory

https://main--bsca-secondsale--aemsites.aem.page/group/fragments/glossary-medicare

^{Blue Shield of California is a PPO plan with a Medicare contract. Enrollment in Blue Shield of California depends on contract renewal.}

^{Out-of-network/non-contracted providers are under no obligation to treat Plan members, except in emergency situations. Please call our Customer Service number or see your Evidence of Coverage for more information, including the cost-sharing that applies to out-of-network services.}

^{Y0118_26_183A_M 08062026}
^{Page last updated: 09/30/2026}