Drug formulary, policy and forms

Effective January 1, 2021, Blue Shield of California pharmacy claims will be processed by CVS Health (CVSH). Please refer to the table below for bank identification number (BIN) and processor control number (PCN) information. For assistance with processing Blue Shield claims, please refer to the Pharmacy Help Desk telephone numbers.

Plan type	BIN	PCN	CVSH Pharmacy Help Desk
Commercial	004336	77993333	(888) 970-0932
Medicare	004336	77993322	(888) 970-0933

Pharmacy benefit design

Find details of the pharmacy benefit, including formulary, medication supply, injectable drug coverage and exclusions.

Pharmacy prior authorization procedures

Find an explanation of procedures for drugs requiring prior authorization and required forms.

Outpatient drug formulary

Access our online drug formularies and download printable versions.

Mail service pharmacy

Get information about CVS Caremark Mail Service, a full-service home delivery pharmacy providing Blue Shield of California members with mail service prescription services.

Generic drug policy

Read a description of Blue Shield of California policy regarding prescription of generic drugs and criteria they must meet to be included in the formulary.

Drug prior authorization forms

Download and print prior authorization forms for oral, topical and home self-administered injectable prescription drugs.

Medication policy

Read about our medication policy for injectable and office-administered drugs.

Online pharmacy authorization request

Submit your pharmacy authorization request for Blue Shield IFP, Small, Large Group and Medicare member online via AuthAccel.