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Accessing Pharmacy Benefits for California Small Groups: Pharmacy Rx BIN and PCN Numbers

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When health insurance consumers enroll in coverage for the first time, change health plans (at any time), or change insurance carriers, they can sometimes experience a delay in accessing pharmacy benefits. This is because of the brief administration period the health plan needs to process such changes.
 
When this occurs, while waiting to receive their new health plan ID Cards, members may use their plan’s Rx BIN and PCN numbers to access pharmacy benefits.
 
The Rx BIN number is a six-digit number health plans use to process electronic pharmacy claims. The PCN (Processor Control Number) identifies each health plan’s drug benefit processor or Pharmacy Benefit Manager (PBM).
 
Rx BIN Numbers and PCNs for California Small Group health plans are shown by carrier in the table below. Your clients may be able to use this information, if necessary, to obtain prescriptions during this short transition period.
 
  Rx BIN Number PCN
Aetna Rx BIN: 610502
Rx Group: Aetna
PCN: 00670000
Anthem Blue Cross Rx BIN: 020099 PCN: IS
Blue Shield of California Rx BIN: 004336 PCN: 77993333
Chinese Community Health Plan Rx BIN: 003585 Rx PCN: ASPROD1
Cigna + Oscar Rx BIN: 003858 PCN: A4
Health Net Rx BIN: 004336 PCN: HNET
Kaiser Permanente - 
Northern CA
HMO
Rx BIN: 3585
Rx Group: Not Required
Tax ID: 94-1340523

Medicare Part D
Rx BIN: 11842
Rx Group: NC
Tax ID: 94-1340523

COB Address
P.O. Box 7012
Downey, CA 90242
Rx PCN for MMA: NCCMS
Rx PCN for HDHP: NCHDP
Rx PCN for HMO: 70000
Kaiser Permanente - 
Southern CA
HMO  
Rx BIN: 3585
Rx Group: Not Required
Tax ID: 94-1340523

Medicare Part D
Rx BIN: 11172
Rx Group: SC
Tax ID: 94-1340523

COB Address
P.O. Box 7012
Downey, CA 90242
Rx PCN for MMA: SCCMS
Rx PCN for HDHP: SCHP
Rx PCN for HMO: 70000
MediExcel Health Plan MediExcel Health Plan is a cross-border health plan. Members must obtain prescriptions at contracted pharmacies in Mexico.

MediExcel Health Plan does not contract with any pharmacy in the U.S.

MediExcel Health Plan will reimburse members for prescriptions obtained as direct result of an Emergency or Urgent Care Service in the U.S. minus their copay amount.
Nippon Life Rx BIN: 004336 PCN: ADV
Sharp Health Plan Rx BIN: 004336 PCN: ADV
Sutter Health Plus Rx BIN: 004336
Rx Group: Rx21CQ
PCN: ADV
Total Benefit Solutions (Aetna International) 610502 (Aetna) PCN: 00670000
United Healthcare HMO Rx Vendor: OPTUMRx
Rx BIN: 610279

Rx PCN: 9999
Rx Grp: UHCNICE
Service Number: 800-788-7871
 
United Healthcare PPO Rx Vendor: OPTUMRx
Rx Bin: 610279

Rx PCN: 9999
Rx Grp: UHC
Service Number: 800-788-7871
 
United Healthcare PPO (Large Group) Rx Vendor: OPTUMRx
Rx Bin: 610279

Rx PCN: 9999
Key Accounts Rx Grp: UHEALTH
Service Number: 800-788-7871
 
Western Health Advantage Rx Vendor: OptumRx
Rx BIN 610011
PCN: IRX

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