Generic drug policy
Generic drugs should be prescribed whenever possible. FDA-approved generic drugs are on the formulary, even if they are not listed. The majority of Blue Shield plans include a lower copayment for generic drugs compared to brand name drugs. Generic drugs must meet the following criteria to be included in the formulary:
- They must contain the same active ingredient as the brand name drug.
- They must be considered to be therapeutically equivalent by the Food and Drug Administration to the brand name drug.
Pharmacy benefit design
Find details of the pharmacy benefit, including formulary, medication supply, injectable drug coverage and exclusions.
Outpatient drug formulary
Access our online drug formularies and download printable versions.
Blue Shield IFP, Small Group, Large Group and Medicare formulary
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.
Drug prior authorization forms
Download and print prior authorization forms for oral, topical and home self-administered injectable prescription drugs.
Find forms for Blue Shield IFP, Small, Large Group and Medicare members
Find forms for Blue Shield Promise Medicare, Medi-Cal and Cal MediConnect members
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.