Blue Shield of California (BSC)
Interested in joining Magellan’s network for BSC Medi-Cal and Medicare plans?
Learn more by emailing [email protected]. To participate, you must also enroll with Medi-Cal through the California DHCS.
California Quick Reference Guide (PDF)
Medical Necessity Criteria
- Medical Necessity Criteria for BSC - see State/Client-Specific Criteria for California
- For key points relating to SB 855, see Handbook Supplement for California (PDF), section 3.
Access Standards
We expect you to return member's call in accordance with good professional practice guidelines. For more information, refer to the California provider handbook supplement, section 3 (PDF).
Maternal Mental Health
BSC offers support to moms-to-be and their partners during and after pregnancy through the Maven Maternity Program.*
Services include:
- On-demand virtual appointments with Maven OB-GYNs, lactation consultants, doulas, mental health specialists, nutritionists, career coaches, and more
- Assigned care advocate to help navigate health plan benefits and providers, and find in-person care
- Educational resources
*In accordance with State Bill 1207 (Health care coverage: maternal and pandemic-related mental health conditions)
Applied Behavior Analysis
- For ABA Initial Authorization and Treatment Request / Concurrent Review forms and contact information, sign in to this website. From the Resources section, select State & Plan Information, then choose Autism.
- For BSC-specific ABA resources, sign in to this website. From the Resources section, select State & Plan Information, then choose Blue Shield of California.
In-Office Injectable Medications
Obtaining In-Office Injectable Medications (PDF)
How to Access In-Office Injectable Policies on BSC Provider Portal (PDF)
Prescription Drug Prior Authorization or Step Therapy Exception Request Form (PDF)
California Provider Information
Visit the California webpage for the California handbook supplement and other important resources, such as a California provider orientation and quick reference guide.
Out-of-Network Providers
Out-of-Network Authorization Request Form -- for out-of-network providers requesting a single case agreement. Contact the phone number on the member ID card for more information.