Members

Explore this page to learn more about your plan and benefits as well as our services and programs.

Visit the Blue Shield Promise Cal MediConnect 2019 Website
Pharmacy Services

Drug Formulary Search
Blue Shield Promise Cal MediConnect Drug Formulary Search & Co-Pays

  • Drug to drug interactions
  • Common side effects & significant risks
  • Availability of generic substitutes

Drug Formulary List
Drug Formulary List in PDF format

Pharmacies
Search for Pharmacies Near You

Find your drug copayment / coinsurance


CVS Caremark
1-866-346-7200 (TTY:711)
You can get prescriptions drugs shipped to your home through our network mail order delivery program which is called "Mail Service Pharmacy".

Coverage Determination & Prior Authorization for Prescription Drugs

Here are the instructions and an online request form for you to find out if your prescription drugs are covered under your plan and instructions for submitting a request for a prior authorization.

Instructions for a Coverage Determination
Online Request for a Coverage Determination
Instructions for a Prior Authorization
Quality Improvement
Quality Improvement
Blue Shield Promise Health Plan (Care1st Health Plan until 12/31/2018) wants to make sure you get good care and services.
Customer Care Operations

ID Card
Request your Blue Shield Promise Health Plan (Care1st Health Plan until 12/31/2018) Member ID Card


PCP Change
Request to Change your Primary Care Physician (PCP)


Treatment Authorization or Referral

Here are instructions on how to request a treatment that requires prior authorization.
Also included are instructions on obtaining a referral from your Primary Care Physician in order to visit a Specialist.

Coverage Determination for Treatment
Prior Authorization for Treatment
Referral for Treatment
Materials & Resources

Member Materials & Publications
Preventive health guidelines, brochures, member newsletters and other materials to keep you informed...

Provider and Pharmacy Directory Request
Request a copy of your Blue Shield Promise Health Plan (Care1st Health Plan until 12/31/2018) Directory

Provider and Pharmacy Directory Search
On-line Search

Member Resources
General Information, Prior Authorizations (Organization and Coverage Determinations) / Exceptions, Appeals & Grievances Process, Forms and more...

Information Inaccuracies

If you believe there is a potential inaccuracy or error in our directory, please let us know using one of the following ways:

By Telephone
1-855-905-3825
TTY/TTD: 711
Hours: 8:00 a.m. - 8:00 p.m., seven days a week
Electronically through our website:
Click Here
In Writing
Blue Shield Promise Health Plan (Care1st Health Plan until 12/31/2018)
Customer Care Operations
601 Potrero Grande Dr.
Monterey Park, CA 91755
Health and Wellness
Health & Wellness web site member login
Log on to the Health & Wellness member web site to take charge of your health. You'll find many tools to help you eat healthier and be more active.
Health Education
Important information on topics like staying fit, managing diseases, healthy eating and maintaining a healthy weight.
Financial Responsibility

Claims Information

If you have any questions about the cost for care you received from your doctor or hospital; or if you receive a bill for a service, please call Blue Shield Promise Health Plan (Care1st Health Plan until 12/31/2018) Customer Care Operations at:

1-855-905-3825
Hours: 8:00 a.m. – 8:00 p.m., seven days a week.
TTY: 711
Hours: same as above.

If you have any questions about the cost for care you received from your doctor or hospital; or if you receive a bill for a service, please call Blue Shield Promise Health Plan (Care1st Health Plan until 12/31/2018) Customer Care Operations at:

1-855-905-3825
Hours: 8:00 a.m. – 8:00 p.m., seven days a week.
TTY: 711
Hours: same as above.

If you have any questions about the cost of a treatment or service for a specific provider or institution, please call Blue Shield Promise Health Plan (Care1st Health Plan until 12/31/2018) Customer Care Operations at:

1-855-905-3825
Hours: 8:00 a.m. – 8:00 p.m., seven days a week.
TTY: 711
Hours: same as above.

Blue Shield Promise Health Plan (Care1st Health Plan until 12/31/2018) is exempt from providing information on the cost of a treatment or service for a specific provider or institution on the Blue Shield Promise Health Plan (Care1st Health Plan until 12/31/2018) member web site for NCQA requirements. Blue Shield Promise Health Plan (Care1st Health Plan until 12/31/2018) has a fully delegated model with over 50 different Medical Groups. The Medical groups are capitated for all professional services. Capitation is a payment arrangement for health care service providers such as physicians or nurse practitioners. It pays a physician or group of physicians a set amount for each enrolled person assigned to them, per period of time.

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Contact Us

If you have any questions about your benefits, please call Blue Shield Promise Health Plan (Care1st Health Plan until 12/31/2018) Customer Care Operations at:

Telephone
1-855-905-3825
Hours: 8:00 a.m. – 8:00 p.m., seven days a week.
TTY: 711
Hours: same as above.
FAX: 1-323-889-5416
Mailing Address:
Blue Shield Promise Health Plan (Care1st Health Plan until 12/31/2018)
Customer Care Operations
601 Potrero Grande Dr.
Monterey Park, CA 91755
Email
Click here to send us an email.

Material ID: H0148_17_014_WEB CMS Pending Approval


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