Plus Drug Formulary for the following California Department of Insurance (CDI) grandfathered plans: Active Start℠ Plan 35-G, Balance Plan 1000-G, Balance Plan 1700-G, Balance Plan 2500-G, Shield Savings℠ 5200-G, Shield Savings℠ 1800/3600-G, Shield Savings℠ 3500-G, Shield Spectrum PPO℠ Plan 5000-G, Vital Shield 2900-G, Vital Shield 900-G, Vital Shield Plus 900 Generic Rx-G
Large Groups (101+ employees)
Learn about different drug coverage topics for members in large group plans.
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 plan’s drug formulary for a list of Blue Shield preferred generic and brand-name medications.
Specialty drug list: Refer to this specialty drug list for specialty drugs that are only available through a Blue Shield Network Specialty Pharmacy. Select drugs may not be available for distribution through the Network Specialty Pharmacy, in which case you may obtain them through a non-network specialty pharmacy.
Preventive drug list (ACA): Refer to this preventive drug list to see drugs for which Health Care Reform (Affordable Care Act or ACA) requires coverage at $0 member share of cost.
Contraceptive drug list: Refer to this contraceptive drugs list to see drugs and devices covered at $0 member share of cost.
HDHP (high-deductible health plans) Preventive drug list: HDHP preventive drugs are specific preventive drugs that may be covered pre-deductible in HDHPs. Refer to your Evidence of Coverage or Certificate of Insurance to determine if you have this benefit.
Vaccine drug list: For eligible non-grandfathered plans, refer to this vaccine list for vaccines covered at participating retail pharmacies and to locate pharmacies available for vaccine administration.
Value-Based Tier drug list: For select Blue Shield plans with the Value-Based Tier Drug (VBTD) benefit, refer to this list for drugs that are covered at no charge, or at an otherwise reduced cost-share. Refer to your Evidence of Coverage or Certificate of Insurance to determine if you have this benefit.
Plus Drug Formulary for the following Department of Managed Health Care (DMHC) plans: Shield Spectrum PPO℠, Full EPO/PPO, Full PPO Savings, Access+ HMO®, Added Advantage POS℠, Local Access+ HMO®, Tandem EPO/PPO, Trio HMO, Active Choice Plus®, Active Choice Classic®, Virtual Blue EPO/PPO
Plus Drug Formulary for Department of Managed Health Care (DMHC) grandfathered plans: Shield Savings℠ 2400/4800-G, Shield Spectrum PPO℠ Plan 2000-G
Value Drug Formulary for the following Department of Managed Health Care (DMHC) plans: Shield Spectrum PPO℠, Full EPO/PPO, Full PPO Savings, Access+ HMO®, Added Advantage POS℠, Local Access+ HMO®, Tandem EPO/PPO, Trio HMO, Virtual Blue PPO Savings
Plus Drug Formulary for the following California Department of Insurance (CDI) plans: Active Choice® 500 80/50, Active Choice® 500 80/50 1500 Deductible, Active Choice® 750 70/50, Active Choice® 750 70/50 1000 Deductible, Active Choice® 750 80/60