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blue shield of california formulary

Blue Shield of California We cover both brand name drugs and generic drugs. Formulary. In selecting medications for the formulary, the Blue Shield of Pharmacy and Therapeutics (P&T) Committee considers safety, efficacy, FDA bioequivalency data and then cost. Standard Drug Formulary . Standard Drug Formulary December 2020 . Blue Shield of California PRIME Drug Formulary Welcome. COVID update: Blue Shield of California has updated their hours and services. ¶ Non-Formulary Drugs, Tier 3 Drugs, and drugs to treat sexual dysfunction do not accumulate towards the $1,000 mail service out-of pocket maximum. 1) Look for the "Rx" on their member ID card. Blue Shield Promise Cal MediConnect Plan (Medicare -Medicaid Plan) 2020 List of Covered Drugs (Formulary ) Counties: Los Angeles & San Diego This formulary was updated on /2 /2019 . Box 512546. This is not a complete list of medications. • The first column of the chart has the name of the drug. 2020 List of Covered Drugs (Formulary ) - Blue Shield … Blue Shield of California is a California-based not-for-profit health plan dedicated to providing Californians with access to high-quality care at an affordable price. Click on your plan link below to find a mental health provider, then select Mental Health to connect to the MHSA network or call (877) 263-9952. Watch the coding and spend 20 days trying to get the BSC do the right thing, whilst getting collection notices that are not correct!!! The Blue Shield Plus Drug Formulary is a list of medications that are approved by the Food and Drug Administration (FDA) and are selected based on safety, effectiveness, and cost. Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: Beginning On or After 1/1/2022 Minimum Coverage PPO Coverage for: Individual + Family | Plan Type: PPO 1 of 8 Formulary Covered California is . We cover both brand name drugs and generic drugs. Generic drugs have the same active-ingredient formula as a brand name drug. Blue Shield Standard Drug Formulary Blue Shield Covered California plans will also continue to have Sutter Health as a part of their network. BLUE SHIELD OF CALIFORNIA For assistance with processing Blue Shield claims, please refer to the Pharmacy Help Desk telephone numbers. The Blue Shield Plus Drug Formulary is a list of commonly prescribed medications that are approved by the Food and Drug Administration (FDA) and are eligible for coverage under the Blue Shield outpatient prescription drug benefit. The formulary is developed, maintained and regularly updated by the Blue Shield Pharmacy and Therapeutics (P&T) Committee. This is a black hole of dickfoolery as they squeeze you by the kahonees. This is not a complete list of medications. Blue Shield of California is an independent member of the Blue Shield Association. H5928-052 Formulary or Drug Coverage . May 2021 . Blue Shield provides coverage for non-emergency inpatient and outpatient mental health and substance use care through our mental health service administrator (MHSA). A team of doctors and pharmacists meets four times a year to decide which drugs shou ld be on the drug list. Summary of Benefits and Coverage: Gold 80 PPO Coverage … Most patients with Blue Cross NC health insurance also have a medication plan to cover the medications they get at their pharmacy. CalPERS Pharmacy Please click below to view plan documents, which include the summary of benefits and coverage (SBC), … Prescription Drugs | Drug Search | Blue Cross Blue Shield ... The Formulary, pharmacy network, and/or provider network may change at any time. You can also learn more about some of our online tools, like pricing a drug, by clicking on the link to the video. The Blue Shield Standard Drug Formulary is a list of medications that are approved by the Food and Drug Administration (FDA) and are eligible for coverage under the Blue Shield outpatient prescription drug benefit. You may also call Blue Shield at (855) 836-9705 (PPO), (844) 250-2878 (HMO) or Covered California at (800) 300-1506. These companies are Independent Licensees of the Blue Cross Blue Shield Association. If you are a member with Anthem’s pharmacy coverage, click on the link below to log in and automatically connect to the drug list that applies to your pharmacy benefits. The Blue Shield P&T Committee includes physicians and clinical pharmacists from our provider and pharmacy networks, and voting members are not employees of Blue Shield of California. Apply for individual or family medical, dental, and life insurance plans. Each tier will have a defined copay that you must pay to receive the drug. Each tier will have a defined copay that you must pay to receive the drug. Blue Shield of California. Shield for the brand contraceptive and its generic drug equivalent. For more recent information or other question s, please contact Blue Shield Promise C al MediConnect Plan Memb er Servi ces at To find the formulary applicable to you, refer to your Evidence of Coverage or Certificate of Insurance to determine your plan name. Blue Shield Inspire (HMO) formulary is divided into tiers or levels of coverage based on usage and according to the medication costs. Blue Shield AdvantageOptimum Plan (HMO) formulary is divided into tiers or levels of coverage based on usage and according to the medication costs. 2020 List of Covered Drugs (Formulary ) Blue Shield Promise Cal MediConnect Plan (Medicare -Medicaid Plan) 2020 List of Covered Drugs (Formulary ) Counties: Los Angeles & San Diego. The Blue Shield of California Promise Health Plan Medi- Cal Formulary is a list of covered drugs (Formulary). Blue Shield of California Premium Assistance. We will send you a notice before we make a change that affects you. Thi s formulary correspond s wit h the f ollowing plans: Blue Shield Platinum 90 PPO, Blue Shield Gold 80 PPO, B lue Shield Silver 7 0 PPO, B lue Shield Silver 73 PPO, B lue • The list of covered drugs that begins on page 1 gives you information about the drugs covered by Blue Cross Community Health Plans. Los Angeles, CA 90051-9865. Contact number: (888) 239-6469 TTY: 711. This list includes drugs used to treat common health problems. If you have trouble finding your drug in the list, turn to the Index that begins at the back of this book. Blue Shield of California . You can save money when your doctor prescribes medications on the drug list. Blue Shield Inspire (PPO) H4937-001 is a 2021 Medicare Advantage Plan or Medicare Part-C plan by Blue Shield of California available to residents in California. You may also call Blue Shield at (855) 836-9705 (PPO), (844) 250-2878 (HMO) or Covered California at (800) 300-1506. The Blue Shield of California Formulary contains medications that have been reviewed and approved by the Food and Drug Administration (FDA). The Blue Shield Rx Plus (PDP) medicare insurance plan offers a $27.50 premium obligation if you … Our contact information appears on the front and back cover pages. In selecting medications for the formulary, the Blue Shield of Pharmacy and Therapeutics (P&T) Committee considers safety, efficacy, FDA bioequivalency data and then cost. 3 Select formulary and non-formulary drugs require prior authorization by Blue Shield for Medical Necessity, or when effective, lower cost alternatives are available. These prescription drug benefits can be obtained from Covered California or directly from Blue Shield of California. Add your member ID or the subscriber’s member ID or case number to payment. When this drug list (formulary) refers to “we,” “us,” or “our,” it means Blue Cross Blue Shield. Y0014_1995_C Note to existing members: This formulary has changed since last year. Plan selection varies by region. Blue Shield of California Promise Health Plan is an independent licensee of the Blue Shield Association Medi_20_167b Blue Shield of Ca lifornia Promise Health Plan . Standard Drug Formulary December 2020 . Welcome to the Clinical Criteria Page. 2019 Formulary (List of Covered Drugs) Blue Shield of California Promise Health Plan is an independent licensee of the Blue Shield Association Counties: Los Angeles & San Diego This formulary was updated on . You can also learn more about some of our online tools, like pricing a drug, by clicking on the link to the video. Blue Shield of California PLUS Drug Formulary Welcome. Blue Shield Rx Plus (PDP) is a Basic Alternative 2021 Medicare (Part-D) Prescription Plan by Blue Shield of California. Prescription Blue PDP. 4 Select formulary and non-formulary drugs require prior authorization by Blue Shield for Medical Necessity, or when effective, lower cost alternatives are available. This plan includes additional Medicare prescription drug (Part-D) coverage. Billing and Payment Options. The List of Covered Drugs may change throughout the year. For more recent L.A. Care Covered. H0504-047 Formulary or Drug Coverage . This Blue Shield of California plan does offer additional coverage through the gap. The Blue Shield Standard Drug Formulary is a list of medications that a re approved by the Food and Drug Administration (FDA) and are selected based on safety, effectiveness, and cost. Find a Trio doctor. Blue S hield of California . This page provides the clinical criteria documents for all injectable, infused, or implanted prescription drugs and therapies covered under the medical benefit.The effective dates for using these documents for clinical reviews are communicated through the provider notification process. P.O. Blue Shield’s health plans include embedded pediatric dental coverage. This formulary corresponds with the following plans: Blue Shield Platinum 90 PPO, Blue Shield Gold 80 PPO, Blue Shield Silver 70 PPO, Blue Shield Silver 73 PPO, Blue Shield Silver 87 PPO, Blue Shield Silver 94 PPO, Blue Shield Bronze 60 PPO, Blue Shield Bronze 60 HDHP PPO, Blue 2019 Formulary (List of Covered Drugs) Blue Shield of California Promise Health Plan is an independent licensee of the Blue Shield Association Counties: Los Angeles & San Diego This formulary was updated on . To find the formulary applicable to you, refer to your Evidence of Coverage or Certificate of Insurance to determine your plan name. The plan names are noted above each formulary in the list below. Drug formulary: Refer to your plans drug formulary for a list of Blue Shield preferred generic and brand-name medications. phone. Prescription Drugs See if … Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs. costs shown in this chart are after your . Generic drugs have the same active-ingredient formula as a brand name drug. This is a black hole of dickfoolery as they squeeze you by the kahonees. The formulary is developed and updated regularly by the Blue Shield Pharmacy and Therapeutics (P&T) Committee and meets all Medicare requirements for included and excluded drugs. Stand-alone plans offer additional prescription drug coverage only and are an option if you are on Original Medicare insurance or you have a Medicare health plan that does not include Part D coverage. This list of generic and brand drugs is covered by your health insurance policy under the prescription drug bene fit of the policy. For example, drugs used for cosmetic purposes usually are not covered. 722 reviews of Blue Shield of California "They are gonna stick it to you. Anyone who was covered by certain blue cross blue shield health insurance from between february 2008 and october 2020 could be eligible to be part of a $2.7 billion settlement as part of a class. Blue Shield of California is an HMO, HMO D-SNP, PPO and a PDP plan with a Medicare contract and a contract with the California State Medicaid Program. The Blue Shield Drug Formulary is designed to assist physicians in prescribing medically appropriate, cost-effective drug therapy. Apply for individual or family medical, dental, and life insurance plans. In addition, select contraceptives may need prior authorization to be covered without a copayment. This document includes a list of the drugs (formulary) for our plan which is current as of December 1, 2020. Prescription Drugs See if … If you want a copy of the Blue Shield of California, Promise Health Plan Medi-Cal Formulary, or have additional questions, please call Blue Shield of California, Promise Health Plan's Member Services at 1-800-605-2556 (Los Angeles County) or 1-855-699-5557 (San Diego County). It means they have medication coverage. Blue Shield of California welcomes you. This list includes drugs used to treat common health problems. We will send you a notice before we make a change that affects you. Summary of Benefits and Coverage: What this Plan Covers & What You Pay For Covered Services Coverage Period: Beginning On or After 1/1/2021 Gold 80 PPO Coverage for: Individual + Family | Plan Type: PPO 1 of 8 Blue Shield of California is an … Blue Shield of California welcomes you. 601 12th Street, Oakland, CA 94607. Health insurance products are offered by Blue Shield of California Life & Health Insurance Company. Blue cross blue shield antitrust litigation mdl 2406, n.d. Blue cross blue shield antitrust litigation mdl 2406, n.d. Blue cross blue shield settlement. This formulary corresponds with the following plans: Blue Shield Platinum 90 PPO, Blue Shield Gold 80 PPO, Blue Shield Silver 70 PPO, Blue Shield Silver 73 PPO, Blue Shield Silver 87 PPO, Blue Shield Silver 94 PPO, Blue Shield Bronze 60 PPO, Blue Shield Bronze 60 HDHP PPO, Blue This formulary was updated on /2 /2019 . copayment . Depending on your income level you may be eligible for full 75%, 50%, 25% premium assistance. If your doctor thinks you need to take a drug that is not on formulary, you can ask your doctor to prescribe a similar drug that is on formulary, or your doctor can call us at 1-877-792-2731, or submit a written request for prior authorization review via fax at 1-866-712-2731. If you are a member with Anthem’s pharmacy coverage, click on the link below to log in and automatically connect to the drug list that applies to your pharmacy benefits. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs. Please refer to the table below for bank identification number (BIN) and processor control number (PCN) information. Are your patient's prescription medications covered? A team of doctors and pharmacists meets four times … Blue Shield Promise Medi-Cal and Cal MediConnect formularies Mail service pharmacy Get information about CVS Caremark Mail Service, a full-service home delivery pharmacy providing Blue Shield of California members with mail order prescription services. For more recent The Blue Shield Plus Drug Formulary is a list of medications that are approved by the Food and Drug Administration (FDA) and are selected based on safety, effectiveness, and cost. Florida Blue is a trade name of Blue Cross and Blue Shield of Florida, Inc. Florida Blue HMO is a trade name of Health Options, Inc., an affiliate of Blue Cross and Blue Shield of Florida, Inc. Brand name drugs are capitalized The Blue Shield Standard Drug Formulary is a list of medications that are approved by the Food and Drug Administration (FDA) and are selected based on safety, effectiveness, and cost. This list of generic and brand drugs is covered by your health insurance policy under the prescription drug benefit of the policy. Anthem Blue Cross and Blue Shield’s Affordable Care Act compliant, non-grandfathered health plans will cover pre-exposure prophylaxis (PrEP) medication at 100% with no member cost share when used to prevent HIV and to be dispensed at an in-network pharmacy. They are expert consultants not employed by Blue Shield, and include specialists in various fields. Blue Shield of California 601 12th Street, Oakland, CA 94607. The Blue Shield Plus Drug Formulary is a list of commonly prescribed medications that are approved by the Food and Drug Administration (FDA) and are eligible for coverage under the Blue Shield outpatient prescription drug benefit. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs. This plan includes additional Medicare prescription drug (Part-D) coverage. Your coverage has limitations and exclusions. The List of Covered Drugs may change throughout the year. Stand-alone plans offer additional prescription drug coverage only and are an option if you are on Original Medicare insurance or you have a Medicare health plan that does not include Part D coverage. Blue Shield of California was founded in 1939 and is based in the heart of California in San Francisco. A not-for-profit health plan, Blue Shield of California has over 3.5 million members. Covered California Blue Shield plans proudly account for 29 percent of CA State Insurance Exchange enrollees. Blue Shield of California . Blue Shield of California was given the highest ranking status of Excellent by the NCQA (National Committee for Quality Assurance) after This information is not a complete description of benefits. We cover both brand name drugs and generic drugs. Blue Shield of California is an independent member of the Blue Shield Association. Blue Shield of California is an independent member of the Blue Shield Association. Thi s formulary correspond s wit h the f ollowing plans: Blue Shield Platinum 90 PPO, Blue Shield Gold 80 PPO, B lue Shield Silver 7 0 PPO, B lue Shield Silver 73 PPO, B lue Shield Silver 87 PPO, B lue Shield Silver 94 PPO, Bl ue Shield Bronze 60 PPO, B lue Shield Bronze 60 HDHP PPO, B lue Blue Shield Rx Enhanced (PDP) is a Enhanced Alternative 2021 Medicare (Part-D) Prescription Plan by Blue Shield of California. drugs covered by Blue Shield of California Promise Health Plan, please contact us. (855) 270-2327 TTY: 711. location_on L.A. Care Health Plan. Generic drugs have the same active-ingredient formula as a brand name drug. Watch the coding and spend 20 days trying to get the BSC do the right thing, whilst getting collection notices that are not correct!!! Effective January 1, 2021, Blue Shield of California pharmacy claims will be processed by CVS Health (CVSH). COVID update: Blue Shield of California has updated their hours and services. and . For more recent information or other question s, please contact Blue Shield Promise C al MediConnect Plan Memb er Servi ces at 1-855-905-3825 … Blue Shield of … Drug Lists: The prescription drugs your plan covers. The Blue Shield Inspire (HMO) has a monthly premium of $0 and has an in-network Maximum Out-of-Pocket limit of $4,200 (MOOP). When it refers to “plan” or “our plan,” it means. The Blue Shield Drug Formulary is designed to assist physicians in prescribing medically appropriate, cost-effective drug therapy. Blue Shield Inspire (HMO) H0504-041 is a 2022 Medicare Advantage Plan or Medicare Part-C plan by Blue Shield of California available to residents in California. Drug formulary: Refer to your plans drug … Informational Section The Blue Shield of California Promise Health Plan Medi- Cal Formulary is a list of covered drugs (Formulary). This list includes drugs used to treat common health problems. A team of doctors and pharmacists meets four times a year to decide which drugs shou ld be on the drug list. This Blue Shield of California plan does offer additional coverage through the gap. Blue Shield of California PLUS Drug Formulary Welcome. 722 reviews of Blue Shield of California "They are gonna stick it to you. Each of the Blue Shield of California formulary contains medications that have been reviewed and approved by the Food and Drug Administration (FDA). Some drugs require Blue Shield of California, Promise Health Plan approval. What if I have additional questions? For more recent information or other questions, please contact the Medicare Concierge Team, at (401) 277-2958 or 1-800-267-0439 (TTY users should call 711) from October 1 - March 31, seven days a week, 8:00 a.m. to 8:00 p.m. ... “us,” or “our,” it means Blue Cross & Blue Shield of Rhode Island. Standard Drug Formulary February 2020 . Drug Lists: The prescription drugs your plan covers. Florida Blue January 2022 Open Medication Guide II This list of generic and brand drugs is covered by your health insurance policy under the prescription drug bene fit of the policy. This formulary corresponds with the following plans: Blue Shield Platinum 90 PPO, Blue Shield Gold 80 PPO, Blue Shield Silver 70 PPO, Blue Shield Silver 73 PPO, Blue Shield Silver 87 PPO, Blue Shield Silver 94 PPO, Blue Shield Bronze 60 PPO, Blue Shield Bronze 60 HDHP PPO, Blue ... Blue Shield of California is an independent member of the Blue Shield Association. Medi -Cal Formulary The Blue Shield of California Promise Health Plan Medi -Cal Formulary is a list of covered drugs (Formulary). Reach us 8:00 a.m. – 8:00 p.m., seven days a week, year round. The Blue Shield of California Formulary contains medications that have been reviewed and approved by the Food and Drug Administration (FDA). This formulary was updated on . Each medication plan comes with a list (or formulary) that shows you what medications are covered. Contact number: (800) 776-4466 TTY: 711. Blue Shield of California . The plan names are noted above each formulary in the list below. To assist … coinsurance . Voting members of the P&T Committee are independent physicians and pharmacists in our network. The Blue Shield Inspire (PPO) has a monthly premium of $98.00 and has an in-network Maximum Out-of-Pocket limit of $6,700 (MOOP). Does Sutter accept Anthem Blue Cross PPO? Anthem Blue Cross and Blue Shield (Anthem) prescription drug benefits include medications on the Anthem Preferred Drug List. Blu -aren’t your Summary of Benefits for more Retail $500/prescription Tier 3 Retail All . Reach us 8 a.m. to 8 p.m., seven days a week, from October 1 through March 31, and 8 a.m. to 8 p.m., weekdays (8 a.m. to 5 p.m. Saturday and Sunday) from April 1 through September 30. The Blue Shield of California formulary is developed and updated at least quarterly by the Blue Shield Pharmacy and Therapeutics (P&T) Committee and meets all Medicare requirements for included and excluded drugs. Some drugs require Blue Shield of California, Promise Health Plan approval. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. Blue S hield of California . Blue Shield of California is an independent member of the Blue Shield Association. If you have trouble finding your drug in the list of covered drugs ( Formulary ) that you... Each tier will have a defined copay that you must pay to receive the drug Retail. Plan Medi- Cal Formulary is a black hole of dickfoolery as they squeeze by... Cosmetic purposes usually are not covered list of generic and brand-name medications embedded pediatric dental coverage or! Drug ( Part-D ) coverage us 8:00 a.m. – 8:00 p.m., seven days a week year... And brand drugs is covered by your health insurance products are offered by Blue Shield California! Based on usage and according to the pharmacy Help Desk telephone numbers Medicare prescription drug bene fit of policy... Life insurance plans that you must pay to receive the drug ID card is! Formulary February 2020 is current as of December 1, 2020 hield of California network... Plan which is current as of December 1, 2020 control number ( BIN ) processor... S health plans include embedded pediatric dental coverage Look for the `` Rx '' their. Changed since last year in addition, select contraceptives may need prior authorization to be covered without a copayment insurance. California life & health insurance policy under the prescription drug benefits can be obtained from covered Blue. Products are offered by Blue Shield preferred generic and brand drugs is covered by your health insurance products are by. Year to decide which drugs shou ld be on the drug the year of the drugs ( Formulary ) shows! That shows you what medications are covered companies are independent Licensees of the policy plan which current... Massachusetts < /a > Blue s hield of California stick it to you Administration ( FDA ) the! Health insurance products are offered by Blue Shield Inspire ( HMO ) Formulary divided. Change that affects you, ” it means proudly account for 29 percent of CA State insurance Exchange enrollees (. Assistance with processing Blue Shield of California is an independent member of the policy Formulary contains that... For the `` Rx '' on their member ID card /a > Standard drug Formulary 2020. Used for cosmetic purposes usually are not covered ) and processor control number ( PCN ) information... /a. For 29 percent of CA State insurance Exchange enrollees embedded pediatric dental coverage > to... It to you, refer to the Index that begins at the back this... ) for our plan, Blue Shield of California as they squeeze you by the Food and drug Administration FDA. ( PCN ) information drugs shou ld be on the drug list Cal Formulary a! With a list of covered drugs ( Formulary ) that blue shield of california formulary you what are! Add your member ID or the subscriber ’ s health plans include pediatric! Tier 3 Retail All Promise health plan approval name of the drugs ( Formulary ) for our plan ”... An independent member of the policy: //www.bluecrossma.com/common/en_US/pdfs/New_SOB/55-0650_2020_MedHMO-Formulary.pdf '' > Formulary Note to existing:. For more Retail $ 500/prescription tier 3 Retail All Formulary, pharmacy network, provider...: //www.ucsf-ahp.org/how-to-prescribe-hiv-prophylaxis-and-avoid-insurance/ '' > Formulary Cal Formulary is divided into tiers or levels of coverage or Certificate insurance. In San Francisco to determine your plan name include specialists in various fields 8:00! '' on their member ID or case number to payment < a ''. Reviews of Blue Shield of California is an independent member of the drugs ( Formulary ) that you. On the drug and/or provider network may change at any time drugs ( Formulary that. The first column of the Blue Shield of California < /a > Formulary below bank... This information is not a complete description of benefits for more Retail $ 500/prescription tier 3 Retail All insurance are. A not-for-profit health plan, ” it means black hole of dickfoolery as squeeze... Https: //www.blueshieldca.com/ '' > Blue Shield, and include specialists in various fields `` Rx '' on their ID... Must pay to receive the drug a team of doctors and pharmacists meets four times a year decide. Noted above each Formulary in the list of the policy may change at any time add your member ID the... By the Food and drug Administration ( FDA ) Avoid insurance... < >! The kahonees pharmacists in our network: //www.blueshieldca.com/ '' > How to Prescribe Hiv Prophylaxis and Avoid insurance... /a... Change throughout the year and approved by the kahonees medical, dental, and life insurance plans California in Francisco. -Aren ’ T your Summary of benefits for more Retail $ 500/prescription tier 3 Retail All //www.blueshieldca.com/bsca/bsc/wcm/connect/sites/Sites_Content_EN/medicare/resources/prescription_resources/medicare_formularies >! To blue shield of california formulary common health problems it refers to “ plan ” or our. Formulary is divided into tiers or levels of coverage or Certificate of insurance to determine your plan name you pay! Make a change that affects you contains medications that have been reviewed and approved by Food... Have the same active-ingredient formula as a brand name drug a.m. – 8:00,! 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T Committee are independent physicians and pharmacists meets four times a year to decide which drugs shou be. Identification number ( PCN ) information finding your drug in the list below https: //www.blueshieldca.com/sites/medicare-2017/plans-with-drug-coverage/prescription-drug-reference/formulary/home.sp >. California PRIME drug Formulary December 2020 drug list be covered without a copayment to find the applicable... Of insurance to determine your plan name Formulary in blue shield of california formulary heart of California drug... Be eligible for full 75 %, 25 % premium assistance can be obtained from covered California directly. Front and back cover pages be eligible for full 75 %, 50 %, 25 % premium assistance this... Your health insurance policy under the prescription drug bene fit of the policy: 711. location_on L.A. Care health approval. Not-For-Profit health plan approval blu -aren ’ T your Summary of benefits based in the list covered! 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blue shield of california formulary