Blue Shield Medicare (PPO)

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
• Prior Authorization
• 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.

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© 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) 370-8852 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

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.