Blue Shield 65 Plus (HMO) Group Plan

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 2024 Formulary Changes
• Printable Formulary
• Spanish Formulary
• Prior Authorization
• Step Therapy Criteria

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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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

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