Find all the information you need to manage your patients’ prescription drugs, including formularies, prior authorization forms, drug quantity limits, and more. Your healthcare provider can request prior approval electronically, by fax or by mail. Site Map | Feedback | Download Adobe Acrobat Reader, Learn more about a Healthier Michigan.org, Blue Cross Blue Shield of Michigan Pharmacy Services, Important Information About Medicare Plans. Before making a final decision, please read the Plan’s Federal brochures (Standard Option and Basic Option: RI 71-005; FEP Blue Focus: 71-017). View the list of drugs, called a "formulary," covered by our plans: 2021. Tier 5 (Non-preferred specialty): $85 copay for up to a 30-day supply; $240 copay for a 31 to 90-day supply. Each non-covered drug has safe and effective, alternative covered drug options. The formulary is a list of our covered prescription drugs, including generic, brand name and specialty drugs. Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. Blue Cross Blue Shield of Michigan and Blue Care Network’s Custom Drug List is a useful reference and educational tool for prescribers, pharmacists and members. The Preferred Drug List is updated monthly. Medication Name ALMOTRIPTAN MAXALT TREXIMET AMERGE MAXALT-MLT UBRELVY AXERT NURTEC ZEMBRACE SYMTOUCH ELETRIPTAN ONZETRA XSAIL ZOMIG ... Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. To give prior approval, we need to confirm two things: that you’re using the drug to treat something we cover and that your healthcare provider prescribes it in a medically appropriate way. The amount you pay for a drug depends on the tier it’s in. ® Registered Marks of Blue Cross Blue Shield of Massachusetts. ® SM Registered and Service Marks of the Blue Cross and Blue Shield Association. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. The preferred alternatives on this list have similar effectiveness, quality and safety, but at a fraction of the cost. We provide health insurance in Michigan. You can also learn more about our prescription drug benefits by following the links below. Prescription Program Drug List — To be used by members who have a three (3) tiered drug plan. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. X. Blue Cross and Blue Shield of Illinois (BCBSIL) offers a wide range of prescription drug plans for our clients. It means they have medication coverage. Determine whether there are prior authorization or site-of-care requirements by reviewing the appropriate drug list: It’s called a Preferred Drug List (PDL). ©1996-document.write(new Date().getFullYear()); Blue Cross Blue Shield of Michigan and Blue Care Network are nonprofit corporations and independent licensees of the Blue Cross and Blue Shield Association. ® Registered Marks of the Blue Cross For more information, view our privacy policy. Register Now. FEP Blue Focus members can apply for coverage of a drug not covered on their formulary with the Non-Formulary Exception Process (NFE) form. Enrollment in Blue Cross Blue Shield of Massachusetts depends on contract renewal. Preferred Drug List Drug list — Three (3) Tier Drug Plan Anthem Blue Cross and Blue Shield (Anthem) prescription drug benefits include medications on the Anthem Preferred Drug List. Nothing for the first 4 prescription fills or refills when you switch from certain brand name drugs to specific generic drugs. Prescription Drugs. How Drugs are Selected for Coverage and Tier Placement Covered drugs on this list are selected and placed into tiers (refer to Member Prescription Benefit section) based Important Legal and Privacy Information | Important Information About Medicare Plans | Privacy Practices Taking Action to Address Racial Health Disparities Learn how Blue Cross and Blue Shield companies are addressing our nation's … How much you pay out-of-pocket for prescription drugs is determined by whether your medication is on the list. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. Your request should include why a specific drug is needed and how much is needed. Covered drugs include prescription drugs and certain over-the-counter (OTC) medicines. Our Formulary (drug list) includes all covered prescription drugs, defines your plan’s drug tiers (how drugs are divided into different cost levels) and identifies how drugs are classified (maintenance, specialty, preventive, etc.) Certain drugs on the list may also require prior authorization or step therapy or quantity limits. The formulary is a list of our covered prescription drugs, including generic, brand name and specialty drugs. See if your drug is covered under your selected plan and compare costs of covered drugs for all three plans. Not Registered? Our three plan options have certain drugs that are not covered on their formularies. AlabamaBlue.com is operated by Blue Cross and Blue Shield of Alabama and all Blue Cross' privacy and security policies regarding the confidentiality and protection of your personal health information apply here as well. A formulary is a list of covered prescription drugs. Blue Cross members can find drug cost estimates or check if a particular drug is on the Blue Cross and Blue Shield of Alabama SourceRx 2.0 Four Tier Prescription Drug List. Proven to be safe, effective, and favorably priced compared to Non-preferred specialty drugs. Get access to your member portal. Check with your employer to make sure you have Anthem Blue Cross or Anthem Blue Cross Life and Health Insurance Company’s Essential Drug List. The amount you pay for a drug depends on the tier it’s in. Tier 4 (Preferred specialty): $65 copay for up to a 30-day supply; $185 copay for a 31 to 90-day supply  1) Look for the "Rx" on their member ID card. Each medication plan comes with a list (or formulary) that shows you what medications are covered. Our prescription drug benefits can offer potential savings when your physician prescribes medications on the drug list. Specialty drugs are limited to a 30-day supply. MBCEBRO-11-3T Commercial Formulary This information applies to members of all Blue Cross & Blue Shield of Rhode Island plans except BlueCHiP for Medicare. The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. You may need to get approval from us for certain drugs. Proven to be safe, effective, and favorably priced compared to Non-preferred specialty drugs. We regularly update this list with medications approved by the U.S. Food and Drug Administration and Your coverage has limitations and exclusions. Internet access is all that’s needed to see if a prescription drug is covered. A drug list is a list of drugs available to Blue Cross and Blue Shield of Texas (BCBSTX) members. Typically the most affordable drug type, and are equal to their brand name counterparts in quality, performance characteristics and intended use. Tier 4 (Preferred specialty): $85 copay for up to a 30-day supply; $235 copay for a 31 to 90-day supply  • Blue Cross Community MMAI is a health plan that contracts with both Medicare and Illinois Medicaid to provide benefits of both programs to enrollees. Tier 1 (Generics): $5 copay for up to a 30-day supply; $15 copay for a 31 to 90-day supply, Tier 2 (Preferred brand): 40% of our allowance ($350 max) for up to a 30-day supply; $1,050 maximum for 31 to 90-day supply. Used to treat complex health conditions. This is a list of drugs that members can get in Blue Shield Promise Cal MediConnect . Cheaper than Non-preferred brands but more expensive than generics. The preferred alternatives on this list have similar effectiveness, quality and safety, but at a fraction of the cost. Free for all members, MyBlue gives you access to exclusive wellness tools that help you live healthy. This is a summary of the features of the Blue Cross and Blue Shield Service Benefit Plan. Proven to be safe, effective, and favorably priced compared to Non-preferred brands. This is a list of drugs that members can get in Blue Cross Community MMAI. We organize our covered prescription drugs into tiers. See our latest drug list changes Essential Drug Lists. You can save money when your doctor prescribes medications on the drug list. Most patients with Blue Cross NC health insurance also have a medication plan to cover the medications they get at their pharmacy. You are about to leave the Blue Cross and Blue Shield of Alabama Medicare products website and go to AlabamaBlue.com. You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. Blue Shield of California patients and their doctors can now compare drug prices right in the exam room Article May 31, 2019 Price transparency critical to addressing prescription drug costs Specialty: Used to treat complex health conditions. Individuals attempting unauthorized access will be prosecuted. The Anthem Blue Cross and Blue Shield Healthcare Solutions (Anthem) PDL includes all medicines covered by Medicaid. These prescription drug lists have different levels of coverage, which are called "tiers." Blue Cross and Blue Shield is pleased to present the 2020 Drug List. Blue Cross' PPO (commercial) For Blue Cross' PPO (commercial) members, select from below: How to submit requests electronically using NovoLogix. For the most recent list of excluded drugs, read our Preferred Drug List Exclusions (PDF). A drug list, is a list of drugs available to Blue Cross and Blue Shield of Illinois (BCBSIL) members. Use our Medication Lookup tool: 2021 Prescription Coverage; Blue MedicareRx℠ plans (PDP) ... 2021 Review the Formulary (Updated 04/01/2021) Blue Cross Blue Shield of Massachusetts is an HMO and PPO Plan with a Medicare contract. Since a drug's status may change and new drugs may be added, we also publish a list of updates to keep you informed of those changes. Are your patient's prescription medications covered? This list is called a formulary. Searching Your Drug List. Check out the changes and updates to our plan in 2021. Prescription Drug List (Formulary) Pharmacy Finder There are no copays for drugs listed on the PDL when you have a prescription from your doctor. Tell us what you really think. The Blue Rx Complete formulary is a list of drugs covered under your pharmacy benefit and developed to serve as a guide for physicians, ... Wellmark Blue Cross and Blue Shield is an independent licensee of the Blue Cross and Blue Shield Association. This is a summary of the features of the Blue Cross and Blue Shield Service Benefit Plan. Each Blue Shield of California Medicare Advantage and Medicare Prescription Drug Plan has a list of drugs it covers. For the most recent drug list updates, including the Preferred Drug List, read our Drug List Updates (PDF). If your drug is in Tier 2, Tier 3 or Tier 5, see if there’s a generic or Preferred drug alternative available and discuss these options with your healthcare provider. Our drug list is reviewed and approved by an independent national committee comprised of physicians, pharmacists and other health care professionals who make sure the drugs on the formulary are safe and clinically effective. Express Scripts, Inc. is a separate company that provides pharmacy services and pharmacy benefit management services on behalf of health plan members. State and Federal Privacy laws prohibit unauthorized access to Member's private information. The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. The Blue Cross and Blue Shield Service Benefit Plan has a variety of pharmacy programs to meet your prescription needs. Typically have a higher cost because these drugs have a Preferred specialty available. All benefits are subject to the definitions, limitations and exclusions set forth in the Federal brochures. 90-day supply may only be obtained after third fill. For refills, call: 1-877-FEP-FILL (1-877-337-3455), Get prescription advice from a registered nurse. Preferred brand name: Proven to be safe, effective, and favorably priced compared to Non-preferred brands. This is a list of preferred drugs which includes brand drugs and a partial listing of generic drugs. The Preferred Drug List (PDF) includes medications that have been selected for their clinical effectiveness, safety, and maximized savings. Drug list exclusions. This is known as prior authorization (PA). Tier 5 (Non-preferred specialty): $110 copay for up to a 30-day supply; $300 copay for a 31 to 90-day supply, Tier 2 (Preferred generic specialty, and Preferred brand specialty): 40% of our allowance ($350 maximum). See how we help keep your out-of-pocket costs low for the medications you and your family need. How much you pay out-of-pocket for prescription drugs is determined by whether your medication is on the list. If your drug is in Tier 2 or not covered, see if there’s a generic or Preferred drug alternative available and discuss these options with your healthcare provider. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Anthem Blue Cross Blue Shield prescription drug benefits include medications available on the Anthem Drug List. Please review the terms of use and privacy policies of the new site you will be visiting. Covers a 22 to 90-day supply. These prescription drug lists have different levels of coverage, which are called "tiers". We organize our covered prescription drugs into tiers. Typically have a higher cost because these drugs have either a generic or Preferred brand available. Visit the. In general, the lower the drug tier the more cost effective the drug. • The List of Covered Drugs and/or pharmacy and provider networks may change throughout the year. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. For the most recent list of excluded drugs, read our Preferred Drug List Exclusions (PDF). This list may be for you if you get your health insurance plan from an employer. By continuing to use this website, you consent to these cookies. The drug list maintains affordable medication access and promotes the use of lower-cost alternatives for members. The full list of drugs that need to be approved, prior approval forms and additional information can be downloaded here. You can access the lists covered in our Medicare Advantage and Medicare Prescription Drug Plans. ® Registered Marks are property of their respective owners. For Standard Option and Basic Option, you will generally pay the lowest cost share for any Tier 1 generic drug or Tier 4 Preferred specialty drug. The drugs on this list are not covered on the commercial Blue Cross Blue Shield Preferred Drug List. Proven to be safe and effective. Our three plan options have certain drugs that are not covered on their formularies, FEP Blue Focus members can apply for coverage of a drug not covered on their formulary with the, Non-Formulary Exception Process (NFE) form, Available to members with Medicare Part B primary only. ... Blue Cross & Blue Shield of Rhode Island is an independent licensee of the Blue Cross and Blue Shield Association. We use cookies on this website to give you the best experience and measure website usage. Coronavirus Update FEP will waive early medication refill limits on 30-day prescription maintenance medications. For account specific information on plans, call your BCBSIL representative. The 2020 Essentials Drug List (Formulary) includes drugs that are covered under a prescription benefit and features a list of excluded drugs. Verify that the member is eligible and has the appropriate benefits. Blue Cross Blue Shield of Massachusetts Formulary: $9 Generic Medication List Last Updated: January 1, 2020 Valid Until: July 1, 2020 The following list includes generic medications covered by plans with the Blue Cross Blue Shield of We will View our list of drugs Value Based Benefit (VBB) Incented Copay Drug List. What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. With FEP Blue Focus, you will generally pay the lowest cost share for any Tier 1 generic drug. The drugs on this list are not covered on the commercial Blue Cross Blue Shield Preferred Drug List. To verify a member's benefit plan or get answers to your pharmacy-related questions, please contact us. Every year, we review our formularies to determine changes based on a drug’s effectiveness, safety, and affordability. Blue Shield Promise Cal MediConnect is a health plan that contracts with both Medicare and Medi -Cal to provide benefits of both programs to enrollees. The protection of your privacy will be governed by the privacy policy of that site. You can see the list of what’s not covered and available alternative options for Standard Option and Basic Option. Physicians are encouraged to prescribe drugs on this list, when right for the member. Members are encouraged to show this list to their physicians and pharmacists. In general, the lower the drug tier the more cost effective the drug. See how your Service Benefit Plan coverage works with different types of prescription drugs. Revision date 11/30/2016 ©2016 Wellmark, Inc. 1 . Our Prescription Drug Cost Tool lets you check drug costs 24/7. These companies are Independent Licensees of the Blue Cross and Blue Shield Association.

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