Prescription Drug Benefits

What to Know

In 2025, Blue Shield of CA is updating its pharmacy program. CVS Caremark Pharmacy will continue to administer retail prescription drug benefits. For mail order services, however, you’ll use Amazon Pharmacy home delivery.

If you’re enrolled in a Kaiser Permanente HMO, Kaiser will continue to administer your prescription drug benefits.

Blue Shield PPO HDHP with HSA

Prescription drug retail benefits: CVS Caremark Pharmacy

Prescription drug mail order benefits: Amazon Pharmacy home delivery

Prescription drug – Retail benefits through CVS Pharmacy
Prescription drug – Mail order benefits through Amazon Pharmacy Home Delivery
In-Network
$10 / $25 / $40 (up to 30-day supply); specialty: 30% up to $200 per prescription
$20 / $50 / $100 (up to 90-day supply); specialty: 30% up to $400
Out-of-Network
25% after deductible + $10 / $25 / $40; specialty: 30% up to $200 per prescription + 25% of purchase price
Not covered

Blue Shield PPO Plan

Prescription drug retail benefits: CVS Caremark Pharmacy

Prescription drug mail order benefits: Amazon Pharmacy home delivery

Prescription drug – Retail benefits through CVS Pharmacy
Prescription drug – Mail order benefits through Amazon Pharmacy Home Delivery
In-Network
$15 / $30 / $50 (up to 30-day supply); specialty: 30% up to $200 per prescription
$30 / $60 / $100 (up to 90-day supply); specialty: 30% up to $400
Out-of-Network
25% + $15 / $30 / $50; specialty: 30% up to $200 per prescription + 25% of purchase price
Not covered

Blue Shield EPO Plan

Prescription drug retail benefits: CVS Caremark Pharmacy

Prescription drug mail order benefits: Amazon Pharmacy home delivery

Prescription drug – Retail benefits through CVS Pharmacy
Prescription drug – Mail order benefits through Amazon Pharmacy Home Delivery
In-Network
$10 / $25 / $40 (up to 30-day supply); specialty: 30% up to $200 per prescription
$20 / $50 / $80 (up to 90-day supply); specialty: 30% up to $400 per prescription
Out-of-Network
Not covered
Not covered

Kaiser Permanente HMO Plan

Prescription drug benefits are administered by Kaiser Permanente

Prescription drug – Retail
Prescription drug – Mail order
In-Network
$10 generic / $25 brand / $25 specialty (up to 30-day supply)
$20 generic / $50 brand (up to 100-day supply)
Out-of-Network
Not covered
Not covered

Medical

Blue Shield

855-599-2657
blueshieldca.com

Member Services
7 a.m.– 7 p.m. PT, Monday–Friday

Teladoc: 800-835-2362
NurseHelp 24/7: 877-304-0504
Access to care outside of CA:
855-599-2657
Access to care outside of U.S.:
855-599-2657

CVS Caremark (retail pharmacy benefits)

866-346-7200

Amazon Pharmacy home delivery (mail order benefits)

855-206-3605

Medical

Kaiser Permanente

Member Services: 800-464-4000 (24/7, except holidays)
Advice Line: 866-454-8855 (24/7)
kp.org