Drug formulary, policy and forms
Search our drug formularies, find benefit and cost information for drugs, learn about our mail service pharmacy, view prior authorization procedures for drugs and find prior authorization forms.
Pharmacy claims processing
Effective January 1, 2025, Blue Shield of California pharmacy claims will be processed by Abarca Health. 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 | Abarca Health Help Desk |
|---|---|---|---|
| Commercial | 026696 | 77993333 | (800) 375-7948 |
| Medicare | 026696 | 77993322 | (800) 375-7924 |
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.
Home delivery pharmacy
Get information about Amazon Pharmacy, 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.
Amazon Pharmacy is independent of Blue Shield of California and is contracted by Blue Shield to provide home delivery of prescription medications to Blue Shield members. Members are responsible for their share of cost as detailed in their benefit plan details. Information about specific prescription drug benefits and drug benefits exclusions can be found in the member’s plan documents. Members may call the customer Service number on their Blue Shield member ID card if they have questions about their Blue Shield prescription drug coverage.