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Blue Shield Promise Cal MediConnect Plan Members

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

Pharmacy Services

Drug Formulary Search
Cal MediConnect Drug Formulary Search & Co-Pays

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

Drug Formulary List - PDF
Copayment/coinsurance - PDF
Search for Pharmacies Near You


CVS Caremark
(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 Coverage Determination
Online Request for Coverage Determination
Instructions for Prior Authorization
Quality Improvement
Quality Improvement
Blue Shield of California Promise Health Plan wants to make sure you get good care and services.
Customer Care Operations

ID Card
Request your Blue Shield of California Promise Health Plan 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 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:

: (855) 905-3825
: 711 (TTY)
: 8:00 a.m. - 8:00 p.m., seven days a week

Electronically through our website:
Click Here
In Writing
Blue Shield of California Promise Health Plan
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
Cost of Treatment

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 of California Promise Health Plan Customer Care Operations at:

: (855) 905-3825
: 711 (TTY)
: 8:00 a.m. - 8:00 p.m., seven days a week

If you have any questions about the cost of a treatment or service for a specific provider or institution, please call Blue Shield of California Promise Health Plan Customer Care Operations at:

: (855) 905-3825
: 711 (TTY)
: 8:00 a.m. - 8:00 p.m., seven days a week

Blue Shield of California Promise Health Plan is exempt from providing information on the cost of a treatment or service for a specific provider or institution on the Blue Shield of California Promise Health Plan member web site for NCQA requirements. Blue Shield of California Promise Health Plan 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 of California Promise Health Plan Customer Care Operations at:

: (855) 905-3825
: (323) 889-5416 (FAX)
: 711 (TTY)
: 8:00 a.m. - 8:00 p.m., seven days a week

:
Blue Shield of California Promise Health Plan
Customer Care Operations
601 Potrero Grande Dr.
Monterey Park, CA 91755

Email
Send us an email

Grievances and Appeals
If you have a complaint, grievance or appeal you may file it at any time. Blue Shield Promise Health Plan will work with you to resolve it.
Grievance Process
Appeal Process
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