Blue Shield Select (PPO) - Alameda County, Orange County & San Diego County

Important Message About What You Pay for Vaccines

Our plan covers most Part D vaccines at no cost to you. Call Customer Service for more information.

Important Message About What You Pay for Insulin

You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on.

Printable Files

The following files require Adobe Acrobat. Download Adobe Acrobat

• Summary of 2025 Formulary Changes
• Printable Formulary
• Spanish Formulary
• Traditional Chinese
• Prior Authorization Criteria
• Step Therapy Criteria
• Step Therapy for Part B Drugs

How to Search For Drugs

• Search by typing part of the generic (chemical) and brand (trade) names.
• Search by selecting the therapeutic class of the medication you are looking for.

If your drug is not included in this formulary, please contact Customer Service and ask if your drug is covered.

If you learn that our plan does not cover your drug, you can ask for an exception to cover your drug. Please see Exceptions and Appeals for more information about how to request an exception.

Y0118_24_461A_C 08092024 H2819_24_461A_C Accepted 08262024  

© Blue Shield of California 1999-2025. All rights reserved. Blue Shield of California is an independent member of the Blue Shield Association.

Contact number: (800) 776-4466 TTY: 711

Reach us 8:00 a.m. – 8:00 p.m., seven days a week.

Blue Shield of California
601 12th Street, Oakland, CA 94607

For assistance in English at no cost, call the toll-free number on your ID card. You can get this document translated and in other formats, such as large print, braille, and/or audio, also at no cost. Para obtener ayuda en español sin costo, llame al número de teléfono gratis que aparece en su tarjeta de identificación. También puede obtener gratis este documento en otro idioma y en otros formatos, tales como letra grande, braille y/o audio.   如欲免費獲取中文協助，請撥打您ID 卡上的免費電話號碼。您也可免費獲得此文件的譯文或其他格式版本，例如：大字版、盲文版和/或音訊版  

The company complies with applicable state laws and federal civil rights laws and does not discriminate, exclude people, or treat them differently on the basis of race, color, national origin, ethnic group identification, medical condition, genetic information, ancestry, religion, sex, marital status, gender, gender identity, sexual orientation, age, mental disability, or physical disability. La compañía cumple con las leyes de derechos civiles federales y estatales aplicables, y no discrimina, ni excluye ni trata de manera diferente a las personas por su raza, color, país de origen, identificación con determinado grupo étnico, condición médica, información genética, ascendencia, religión, sexo, estado civil, género, identidad de género, orientación sexual, edad, ni discapacidad física ni mental. 本公司遵守適用的州法律和聯邦民權法律，並且不會以種族、膚色、原國籍、族群認同、醫療狀況、遺傳資訊、血統、宗教、性別、婚姻狀況、性別認同、性取向、年齡、精神殘疾或身體殘疾而進行歧視、排斥或區別對待他人。 Click here for more information.