Select one of these plans to find more information about outpatient prescription drug coverage under your benefits. Refer to the drug formulary for a list of Blue Shield preferred generic and brand-name medications. The Formulary is a guide that helps our members choose cost-effective drug therapy. Additional guides are also available.

 

Medicare Part D

Click the links to learn about Medicare Part D prescription drug formularies.

 

Individual and Family Plan and Small Groups (1-100 employees) including Covered California*

Learn about different drug coverage topics for members in Individual and Family Plans (IFP) or small group plans. These prescription drug benefits can be obtained from Covered California or directly from Blue Shield of California.

2018 Standard drug formulary

2019 Standard Drug Formulary

*For members in grandfathered IFPs, refer to the Plus drug formulary (PDF, 4.42MB)

Refer to this specialty drug list for specialty drugs that are only available through a Blue Shield Network Specialty Pharmacy. Select drugs may not be available for distribution through the Network Specialty Pharmacy in which case it may be obtained through a non-network specialty pharmacy.

Refer to this preventive drug list to see drugs for which health reform requires coverage at $0 member share of cost.

Refer to this contraceptive drugs list to see drugs and devices covered at $0 member share of cost.

For eligible non-grandfathered plans, refer to this vaccine list for vaccines covered at participating retail pharmacies and to locate pharmacies available for vaccine administration.

 

Large Groups (101+ employees)

 Learn about different drug coverage topics for members in large group plans.

2018 Plus drug formulary

2019 Plus drug formulary

2019 Value drug formulary

Refer to this specialty drug list for specialty drugs that are only available through a Blue Shield Network Specialty Pharmacy. Select drugs may not be available for distribution through the Network Specialty Pharmacy in which case it may be obtained through a non-network specialty pharmacy.

For members with a mandatory mail service or maintenance drug benefit, refer to this maintenance list for drugs that you should fill at the mail service pharmacy. Blue Shield's mail service pharmacy may also fill other maintenance drugs not listed.

Refer to this preventive drug list to see drugs that health reform requires to be covered at $0 member share of cost.

Refer to this contraceptive drug list to view drugs and devices covered at $0 member share of cost.

For select Blue Shield plans with the Value-Based Tier Drug (VBTD) benefit, refer to this list for drugs that are covered at no charge, or at an otherwise reduced cost-share. Refer to your Evidence of Coverage or Certificate of Insurance to determine if you have this benefit.

For eligible non-grandfathered plans, refer to this vaccine list for vaccines covered at participating retail pharmacies and to locate pharmacies available for vaccine administration.

 

If you are a Blue Shield member, you should check your Evidence of Coverage booklet/Certificate of Insurance/Policy to find out about drug coverage and how our formulary may apply to your specific plan.

Our prescription drug formularies are updated monthly. Formulary change announcements are updated quarterly, read about the recent changes.