Blue Cross and Blue Shield of Alabama offers health insurance, including medical, dental and prescription drug coverage to individuals, families and employers. d/b/a Highmark Blue Shield, Highmark Benefits Group Inc. Blue Medicare Prime Therapeutics® Pharmacy and Therapeutics (P&T) Committee, in association with Blue Cross and Blue Shield of Alabama’s Formulary Business Committee, recently approved updates to the Drug Guides and made clinical program changes to select medications. MT, 7 a. Blue Cross and Blue Shield of Texas (BCBSTX) is pleased to present the 2021 Drug List. bcbsil. Blue Cross Blue Shield of Michigan and Blue Care Network . Insurance Services KeyRx Drug Formulary, July 2021 II This Blue Cross KeyRx list shows prescription drug products in tiers. The Drug List includes both brand name and generic drugs. Y0138_081020FF05_C F10956R03 12/20 Blue Cross and Blue Shield ® of Minnesota and Blue Plus® are nonprofit independent licensees of the Blue Cross and Blue Shield Association. Jun 22, 2021 · New Preferred Drugs. BCBSAZ covers the medications listed as long as: The medication is medically necessary and appropriate. We regularly update this list with medications approved by the U. Food and Drug Administration (FDA) that we I Drug Formulary, October 2021 Introduction Blue Cross and Blue Shield of Minnesota, Blue Plus and the Student Health Benefit Plan are pleased to present the FlexRx drug formulary (drug list). g. $517. Generally, if you’re taking a drug on our 2021 formulary that was covered at the beginning of the year, we won’t discontinue or reduce coverage of the drug during the 2021 coverage year except as described above. Blue Cross and Blue Shield of Illinois October 2021 Basic Annual Drug List II How to use this list Generic drugs are shown in lower-case boldface type. *Preferred Pharmacy Network pricing isn’t available for 100% cost-sharing plans. Last Updated: Feb. to 6 p. Our goal is to give members access to safe and effective prescription drugs at a reasonable cost. Also known as drug formulary or prescription drug list. Pharmacists and doctors at Blue Cross Blue Shield of Comments, questions and requests for formulary additions are encouraged and should be directed to: Blue Shield Pharmacy and Therapeutics Committee c/o Pharmacy Services Department P. reviewed by Blue Cross Blue Shield of Arizona through the formulary exception review process. Self & Family (112) $262. Medications not listed on the formulary are considered to be non-formulary and are subject to prior authorization. m. Preferred Prescription Drug List (PDL) Updates Effective January 1, 2024 Please Note: To better promote cost-effective utilization, certain medications will be replaced with effective but lower-cost alternatives. Existing Members: Request to receive a printed Drug Formulary by mail. , along with Express Scripts, an independent company that serves as our pharmacy benefit manager, created this Covered Drug List to help you understand your drug benefits. The list includes both brand-name and generic drugs. The Standard Option and Basic Option formularies have five tiers of drugs. The list is called a "drug list" or "drug formulary. Our goals are to provide you with safe, high-quality prescription drug therapies and keep your medical costs low. We partner with CarelonRx Specialty Pharmacy and other pharmacies to meet all your specialty medication needs. Learn how BCBSKS meets your prescription drug needs. June 22, 2021. If you are in a special enrollment category, contact the agency or Tribal employer that manages your health benefits enrollment. They may be preferred brand drugs, based on how well they work and their cost compared to other drugs used for the same type of treatment. You can search or print your drug list from the options below. You’ll save money when you use these drugs instead of non-preferred drugs. Prime Therapeutics LLC (Prime) is a pharmacy benefit management company, contracted by BCBSOK to provide pharmacy benefit management and related other services. " Blue Cross and Blue Shield April 2024 Multi-Tier Basic Drug List – Updated 4/1/24 I Introduction Blue Cross and Blue Shield is pleased to present the 2024 Drug List. Members are encouraged to show this list to their Blue Cross and Blue Shield is pleased to present the 2021 Drug List. Sep 19, 2022 · You can also call the Customer Service number on your Blue Cross Blue Shield of Oklahoma member ID card. You can save money when your doctor prescribes medications on the drug list. These drug lists are a list of drugs considered to be safe and effective. If a request isn’t approved, we’ll notify you and the doctor in writing. This search does not guarantee prescription drug coverage. If you have a complex or chronic health condition that requires special medicine, we can help. 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. However, you may still obtain a copy by logging into your my BlueCross account, or request a copy by calling the customer service phone number on the back of your ID card. Drug Lists: The prescription drugs your plan covers. Blue Cross and Blue Shield of Illinois, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association SBC IL Non-HMO IND-2021 Page 1 of 7 The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. %PDF-1. Medications not listed on this formulary (non-formulary medications) are not covered. If your health plan includes Blue Cross and Blue Shield of Texas (BCBSTX) prescription drug benefits, these are administered by Prime Therapeutics, the pharmacy benefits manager (PBM). Blue Cross and Blue Shield October 2021 Basic Drug List I Introduction . Members are encouraged to show this list to their physicians and pharmacists Blue Cross and Blue Shield of Texas Medical Drug Benefit List. The medication has been approved by the Food and Drug Administration (FDA) for the Apr 1, 2024 · Effective 04/01/2024. Blue Cross and Blue Shield is pleased to present the 2021 Drug List. See p. We provide medical necessity exceptions for some of these limits when you request and receive prior authorization for them. 280-471 (01/2022) Blue Cross and Blue Shield of Vermont 1 National Performance Formulary Prescription Drugs and Biologics Rider Your Certificate of Coverage is amended as described in this document. . Physicians are encouraged to prescribe drugs on this list, when right for the member. This The National drug list is for members who receive a health insurance plan from an employer, if they have certain grandfathered plans, or in some cases if coverage is through a Small Group employer. Call: 1-800-671-6081 (TTY 711) Monday - Friday, 8 a. the. 2021 Formulary (List of Covered Drugs) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN . Sep 27, 2021 · Highmark Inc. ET, 8 a. Members will receive a letter from Blue Cross if they are negatively affected by a formulary We would like to show you a description here but the site won’t allow us. Your benefits are applied automatically so you know right away what out-of-pocket costs may be your responsibility. " Blue Cross and Blue Shield of New Mexico (BCBSNM) will pay for medicines on this list. The following entities serve central and southeastern Pennsylvania and are independent licensees of the Blue Cross Blue Shield Association: Highmark Inc. We have a team of doctors and pharmacists—our Pharmacy and Therapeutics Committee (P&T)—who review our formulary for safety and effectiveness. For more recent information or other questions, please contact Horizon Blue Cross Blue Shield of New Jersey at . Search to see drugs covered under this Benefit Plan. This list is subject to change without notification. Jul 12, 2021 · Formulary. If you have any questions about coverage of a certain product, please contact us at 1-844-396-2330. the best value compared to other drugs that treat the same conditions. Blue Cross and Blue Shield October 2021 Enhanced Annual Drug List I Introduction Blue Cross and Blue Shield is pleased to present the 2021 Drug List. 60. com as preferred infliximab brands, in addition to Remicade, when infliximab is deemed medically necessary per policy II-97. Plus, you have access to up-to-date coverage information in your drug list, including – details about brands and generics, dosage/strength options, and information about prior authorization of your drug. Blue Cross and Blue Shield of Texas October 2021 Balanced Drug List I Introduction Blue Cross and Blue Shield of Texas (BCBSTX) is pleased to present the 2021 Drug List. • This information may be available in a dierent format. Formulary ID: 00021247, Version: 20 This formulary was updated on November 1, 2021. 63. KeyRx Drug Formulary, January 2021 II This Blue Cross KeyRx list shows prescription drug products in tiers. all generics in one tier). $568. Health care providers who have questions about the formulary and its use can contact: Pharmacy Service Center 1-800-600-2227 option 2. From Oct. The reference brand is a non- formulary (non-p Prescription Drug Lists--. Pharmacy Services — Mail Code 512C Blue Cross Blue Shield of Michigan 600 E. Quantity Management – This program limits the amount we cover for certain drugs. This plan goes by a list of approved drugs. Physicians are encouraged to prescribe drugs on this list, when right for the Blue Cross and Blue Shield of Texas Medical Drug Benefit List. Understanding Your Covered Drug List Blue Cross and Blue Shield of Louisiana and our subsidiary, HMO Louisiana, Inc. View your drug list effective January 1, 2024: 2024 Basic Drug List Blue Cross and Blue Shield of Texas (BCBSTX) is pleased to present the 2021 Drug List. Beginning July 1, 2021, the following drugs will be considered non-preferred by BlueCross BlueShield of South Carolina. Find a pharmacy. 03. This document includes a list of the drugs (formulary) for our plan, If you no longer qualify for Medicaid, we can help you find the right health coverage. 2021 FORMULARY — 5 TIER (LIST OF COVERED DRUGS) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN 21155, Version 21 This formulary was updated on 12/01/2021. Physicians are encouraged Blue Cross and Blue Shield October 2021 Multi-Tier Basic Drug List II How to use this list Generic drugs are shown in lower-case boldface type. How much you pay out-of-pocket for prescription drugs is determined by whether your medication is on the list. These prescription drug lists have different levels of Blue Cross Blue Shield of Michigan Clinical Drug List The Blue Cross Blue Shield of Michigan Clinical Drug List is a useful reference and educational tool for prescribers, pharmacists and members. Please review this document to make sure it still contains the drugs you take. Through our Preferred Medical Drug List initiative, our Pharmacy and Therapeutic (P&T) Committee identifies preferred medical drug products in a variety of categories and implements strategies to encourage the use of effective and lower cost medicines. These drugs are considered to be safe and cost-effective. Your prescription drug coverage provides benefits for drugs listed on the Regence BlueCross BlueShield of Utah Essential Formulary. A prescription drug list is a list of drugs available to Blue Cross and Blue Shield of Oklahoma (BCBSOK) members. , Highmark Health Insurance Company, Highmark Choice Company or Highmark Senior Health Company. Legend: $ = under $100, $$ = $100-$250, $$$ = $251 -$500, $$$$ = $501-$1,000, $$$$$ = over $1,000, A = drug not subject to medical deductible or member cost share, * = drug may require prior authorization in order to be covered, SoC Blue Cross and Blue Shield October 2021 Basic Drug List I Introduction . Our prescription drug benefit designs help you make the most of your healthcare dollar - by making smart decisions about prescription drugs. 2021 2021 FORMULARY (LIST OF COVERED DRUGS) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN This formulary was updated on 12/01/2021. This means that the current, non-preferred drug will still be covered, but the member’s cost share will be increased. These include: A letter was sent to affected members on October 30 and asked them to contact their provider about alternative treatments. S. Physicians are encouraged to prescribe drugs on this list, when right for the May 7, 2024 · The drug lists below are used with BCBSTX "metallic" health plans that are offered through your employer. When it refers to “plan” or “our plan,” it means Medicare PPO Blue SaverRx, Medicare PPO Blue ValueRx, and Medicare PPO Blue PlusRx. With this policy update, the Commercial Medical Drug Exclusion List will be archived and a Commercial Preferred Medical Drug List will be posted. O. Members are encouraged to show this list to their physicians and pharmacists. Lafayette Blvd. This is a list of preferred drugs which includes brand drugs and a partial listing of generic drugs. Doctors and pharmacists developed this list — and occasionally make updates to it — based on safety, efficacy and KeyRx Drug Formulary, January 2021 II This Blue Cross KeyRx list shows prescription drug products in tiers. Jan 1, 2021 · January 2021 Specialty Pharmacy Prior Authorization Drug List: New Codes Added, Effective Jan. Blue Cross and Blue Shield of Oklahoma (BCBSOK) is pleased to present the 2021 Drug List. For example, drugs used for cosmetic I Drug Formulary, April 2021 Introduction Blue Cross and Blue Shield of Minnesota, Blue Plus and the Student Health Benefit Plan are pleased to present the FlexRx drug formulary (drug list). May 3, 2021 · If you’re reviewing your health insurance coverage, or thinking about choosing a new plan, you may run into the term “drug list” or “drug formulary. Specialty pharmacy. Please contact Customer Service at the numbers listed below if you need plan information in another format or language. PT. This document can assist practitioners in selecting clinically appropriate and cost-effective products for their patients. Talk to a health plan consultant: 833-828-6962 (TTY: 711) Mon-Fri, 8 am to 8 p. Simply present your prescription and BCBSWY ID card to the pharmacist. If a member or provider feels there are no suitable formulary alternatives available, he or she may request that an exception be made to allow coverage for a non-formulary medication by filling out the Non-Formulary Exception Request Form. To receive material in an alternative format or language, call Blue Cross Medicare Advantage at the number above. Both preferred and non-preferred drugs require prior authorization (PA The Blue Cross Blue Shield of North Dakota (BCBSND) BlueCare, BlueDirect and BlueEssential/Simply Blue formulary contains covered drugs for a broad range of diseases. Visit Prime Therapeutics to: Search for prescription drugs. 05, 2024. If you go to a pharmacy that is not in our network, you pay the full Blue Cross Community Centennial includes prescription drug coverage. 7 %âãÏÓ 28037 0 obj > endobj 28098 0 obj >/Encrypt 28038 0 R/Filter/FlateDecode/ID[10469C8783B2C540A43507C64D0D05AA>]/Index[28037 152]/Info 28036 0 R Medications not listed on the formulary are considered to be non-formulary and are subject to prior authorization. 2021 Formulary (List of Covered Drugs) This booklet provides information about the drugs we cover in if you need plan information in another format or language. Pittsburgh, PA 15222. BCBSKS prescription drug benefits may include access to retail, mail delivery and specialty pharmacies. Additionally, if a medication is available as a generic formulation, this will be Anthem's preferred agent, unless otherwise noted. All excluded drugs have a therapeutic alternative. This is the list of covered medications chosen by the BCBSAZ Pharmacy & Therapeutics (P&T) Committee, which is made up of community doctors and pharmacists. We notify the doctor of approved requests and process the claim accordingly. Members, contact your employer or the Pharmacy Member Services number on your ID card if you need assistance in identifying your plan. Please refer to all sections Sep 13, 2021 · Horizon formularies encourage the use of safe, effective and affordable drugs by our members. 1, 2021. In some cases, an over-the-counter (OTC) drug may Jun 1, 2024 · A formulary is a list of covered drugs under a Medicare Advantage Part D Plan. name, and specialty drugs, as well as Preferred drugs that will lower your out-of-pocket costs. Drugs that are not shown are not covered. This preferred product change applies to commercial subscribers. Self + 1 (113) $238. This program benefits members with conditions requiring specialty medications. The FEP Blue Focus formulary has two tiers of drugs. This list is a sample of commonly prescribed generic and preferred brand drugs. To help Blue Cross and Blue Shield of Kansas City (Blue KC) is an in dependent licensee of the Blue Cross Blue Shield Association. The drug list information below applies to members with prescription drug coverage through BCBSMT, covering such health plans as including individual and employer-offered plans, Medicare and Medicaid government plans and metallic plans offered on and off HPMS Approved Formulary File Submission ID 21194, Version Number 8 Y0079_9270_C_PA 08312020 • • Benefits, premium and/or copayments/coinsurance may change on January 1 of each Search Drug List and Find a Pharmacy. Detroit, MI 48226-2998 Doctors can request authorization for you. A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association . You can save money by choosing drugs on the list, especially if they are generic drugs. 2021 Medicare Advantage Plans Offered by Blue Cross and Blue Shield Companies 9 State Regional PPO Local PPO HMO HMO- POS PFFS Cost SNP Blue Cross and Blue Shield Plan Sponsor Product Name Blue Cross Blue Shield of Massachusetts Medicare HMO Blue SaverRx (HMO) Blue Cross Blue Shield of Massachusetts Medicare HMO Blue ValueRx (HMO) Blue Cross and Blue Shield of Montana (BCBSMT) drug lists, are provided as a guide to help in the selection of cost-effective drug therapies. Each drug is placed into one of four member payment tiers: Tier 1, Tier 2, Tier 3, and Tier 4. is a subsidiary of Blue Cross and Blue Shield of Louisiana. Blue Cross Group MedicareRx (PDP) 2021 Formulary (List of Covered Drugs) Note to existing members: This formulary has changed since last year. ” This is a list your health insurance company keeps that includes all covered prescription drugs, both generic and brand name. These prescription drug lists have different levels of coverage, which are called "tiers. to 5 p. A list of prescription drugs selected for their medical effectiveness, positive results and value. These rates do not apply to all enrollees. The Premium Formulary list includes many of the drugs your plan covers. Legend: $ = under $100, $$ = $100-$250, $$$ = $251-$500, $$$$ = $501-$1,000, $$$$$ = over $1,000, A = drug not subject to medical deductible or member cost share, * = drug may require prior authorization in order to be covered, SoC Prescription Drug Formulary Search. CT, 7 a. BCBSOK, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics LLC. The formulary is a list of Food and Drug Administration (FDA)-approved prescription generic, brand-name and specialty drugs. These can include Platinum, Gold, Silver, or Bronze plans. Physicians are Drug Lists. Physicians are encouraged KeyRx Drug Formulary, July 2021 II This Blue Cross KeyRx list shows prescription drug products in tiers. to 8 p. Physicians are encouraged to prescribe drugs on this list, when right for the member Florida Blue is a trade name of Blue Cross and Blue Shield of Florida, Inc. KeyRx Drug Formulary, July 2021 II This Blue Cross KeyRx list shows prescription drug products in tiers. to 7 p. Note: Depending on your benefit plan, drugs can either be in these tiers or you may have fewer tiers (e. These companies are Independent Licensees of the Blue Cross Blue Shield Association. Food and Drug Administration and reviewed by our Pharmacy and Therapeutics Committee. We are pleased to provide the 2024 Arkansas Blue Cross and Blue Shield Complete Formulary as a useful reference and informational tool. On January 3 2021 Covered Drug List 04HQ1509 R10/20 HMO Louisiana, Inc. Nov 5, 2020 · As a result, some drugs have been added to the Essential Drug List Exclusion List starting January 1, 2021. Alternatives for nonpreferred and nonformulary (not covered) drugs. If your company has 1–50 employees, your prescription drug benefits through BCBSTX are based on a Drug List, which is a list of drugs considered to be safe and effective. Most generic drugs are followed by a reference brand drug in (parentheses). Generic drugs are shown in lower -case boldface type. Each drug is placed i nto one of four member payment tiers: Tier 1, Tier 2, Tier 3, and Tier 4. When this formulary (drug list) refers to “we,” “us,” or “our,” it means Blue Cross Blue Shield of Massachusetts. However Four-Tier Covered Drug List 04HQ1444 R09/20 HMO Louisiana, Inc. , an affiliate of Blue Cross and Blue Shield of Florida, Inc. 1-800-391-1906 4 Not available for all groups. Physicians are encouraged Horion Blue Cross Blue Shield prescription pharmacy list and drug list for individuals. PRESCRIPTION DRUG LISTS. A drug list is a list of drugs available to Blue Cross and Blue Shield of Texas (BCBSTX) members. When this drug list (formulary) refers to “we”, “us”, or “our”, it means, HCSC. 4 NON-COVERED DRUGS There are certain drugs approved by the U. Tier 2: Tier 2 drugs have a higher cost share than Tier 1. Some are generic drugs that may cost more because they’re newer to the market. This Rider becomes a part of your Contract and is subject to all provisions. Oct 1, 2023 · Standard Drug Formulary for the following Department of Managed Health Care (DMHC) plans: IFP: $0 Cost Share, Bronze 60 HDHP PPO, Bronze 60 PPO, Bronze 7500 Trio HMO, Gold 80, Minimum Coverage PPO, Platinum 90, Silver 1750 PPO, Silver 2600 HDHP PPO, Silver 70 Off Exchange, Silver 70, Silver 73, Silver 87, Silver 94. Step Therapy – Step therapy requires members to try cost-effective “First Choice” medications before trying (or Blue Cross and Blue Shield October 2021 Basic Drug List I Introduction . 1 - March 31 representatives are also available 2 2021 Formulary Changes that won’t affect you if you’re currently taking the drug. Blue Cross Blue Shield of Massachusetts Formulary: Affordable Care Act (ACA) Covered Medication List Last Updated: August 1, 2022 The following list includes medications that are covered by plans with the Blue Cross Blue Shield If you have any questions about your pharmacy benefit, call 800-210-7628 24 hours a day, seven days a week. Preferred Drug List . The reference brand drug is usually a non-preferred (NP) brand and is only included as a reference to the brand. Your coverage has limitations and exclusions. For more recent information or other questions, please contact Blue Cross Blue Shield of Massachusetts at 1-800-200-4255, or, for TTY users, 711, from May 7, 2024 · If your company has 1–50 employees, your prescription drug benefits through BCBSIL may be based on the Basic Drug List, Basic Annual Drug List, Enhanced Drug List or the Enhanced Annual Drug List. To help ensure reviews for medical necessity and site of administration are being conducted according to member benefit plan details, 14 new procedure codes have been added to the Specialty Pharmacy Prior Authorization Drug List, effective Jan. See the full and up-to-date Blue Cross and Blue Shield of Illinois prescription drug lists at . Jun 1, 2024 · 2024 Comprehensive Formulary (List of Covered Drugs) • Benets, formulary, pharmacy network, premium and/or copayments/coinsurancemay change on January 1 of each year. Box 7168 San Francisco, CA 94120-7168 Phone: (800) 535-9481 Fax: (888) 697-8122. Florida Blue HMO is a trade name of Health Options, Inc. Based on recommendations from our P&T Committee, we occasionally Getting your medications at any of the 55,000+ pharmacies in our pharmacy network is easy. Originally published 4/1/2016; Revised 2020, 2021, 2022 Blue Cross and Blue Shield of Illinois October 2021 Multi-Tier Basic Annual Drug List I Introduction Blue Cross and Blue Shield of Illinois (BCBSIL) is pleased to present the 2021 Drug List. For more recent information or other questions, please contact Blue Cross Blue Shield of Massachusetts at 1-800-200-4255, or, for TTY users, 711, from April 1 through OCTOBER 2021 BLUE CROSS AND BLUE SHIELD OF ALABAMA 1 Drug Guide and Clinical Program Updates Prime Therapeutics® Pharmacy and Therapeutics (P&T) Committee, in association with Blue Cross and Blue Shield of Alabama’s Formulary Business Committee, recently approved updates to the Drug Guides and made clinical program changes to select medications. Last updated on 9/27/2021 4:43:46 PM. A drug list, is a list of drugs available to Blue Cross and Blue Shield of Illinois (BCBSIL) members. All available covered drugs are shown on this list. July 12, 2021. These prescription drug lists have different levels of coverage, which are called "tiers". The list includes generic or preferred brands to treat many common conditions. How much you may pay out-of-pocket for prescription drugs is determined by whether your medication is on the Drug List. If you are not a current member, call to speak with one of our dedicated Medicare Consultants to request to receive a printed Formulary book by mail. Blue Cross and Blue Shield of Wyoming NetResults Formulary, January 2021 III • Strict compliance and patient support • Additional education and support required from a health care professional • Usually not stocked at retail pharmacies • May only be available through limited distribution arrangements Aug 1, 2022 · Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. Anthem Individual and Family plans can be an affordable option for you and your family. 96. See if your medicines are covered, get pricing and learn about ways to save Jan 1, 2021 · Blue Cross Medicare Advantage depends on contract renewal. 120 Fifth Avenue, FAPHM-141B. Both companies are independent licensees of the Blue Cross and Blue Shield Association. Blue Cross and Blue Shield of Texas October 2021 Performance Drug List I Introduction Blue Cross and Blue Shield of Texas (BCBSTX) is pleased to present the 2021 Drug List. mklcbwsmytgmxfqhnemd