are the legal entities which have contracted as a joint enterprise with the Centers Drugs on the formulary are organized by tiers. Express Scripts develops formularies based on the following principles: 1. It features low $1 copays for tier 1 prescription drugs. Prior authorization phone and fax numbers All prior authorizations will be managed by MedImpact. Use the formulary to search by drug name or disease category: For Medi-Cal drug coverage, please use the Medi-Cal Contract Drug List. SM, TM Registered and Service Marks and Trademarks are property of their respective owners. Naley zadzwoni do Dziau obsugi ubezpieczonych pod numer podany na identyfikatorzezadzwo1-800-472-2689(TTY: 711 ). All pharmacy services billed as a pharmacy claim (and their electronic equivalents), including outpatient drugs (prescription and over the counter), physician- administered drugs (PADs), medical supplies, and enteral nutritional products are in scope for pharmacy under Medi-Cal. Anthem Blue Cross is the trade name of Blue Cross of California and Anthem Blue Cross Partnership Plan is the trade name of Blue Cross of California Partnership Plan, Inc. Please contact the plan for further details. CCC Plus: 1-855-323-4687 ET, seven days a week. To submit electronic prior authorization (ePA) requests online, use Availity. 1-800-472-2689(TTY: 711) . Getting your prescriptions filled is easy. Quantity supply limits and dose optimization, Visit the Centers for Medicare & Medicaid Services website for the latest news on the e-Rx Incentive Program, Assistive Devices and Walker/Wheelchair Accessories, Privacy Guidance When Selecting Third-Party Apps, Privacy Guidance When Selecting Third-Party Apps - Spanish. Certain generic drugs that are available at the lowest copayment for our members, Higher cost generic drugs available at a higher copayment than Tier 1 generic drugs, Common brand-name and some higher cost generic drugs, High cost generic and non-preferred drugs, many of which may have lower cost options available on Tier 1, 2 or 3, Unique and/or very high-cost brand and some generic drugs of which you pay a percentage of the drug cost; some may require special handling and/or close monitoring, Prior authorization you will need to obtain approval before you fill your prescription, Quantity limit There is a limit to the amount of the drug the plan will cover with each prescription filled, Step therapy You may be required to try an alternative drug before this drug is covered, Limited access This prescription may be available only at certain pharmacies. How to use the Anthem Blue Cross Cal MediConnect Formulary. Additionally, Anthem offers a statewide Health Maintenance Organization Plan Option for eligible members and pre-65 Retirees, as well as Medicare Advantage Premium and Standard Plan Options to Medicare-eligible members. Please direct FFS PA requests and PDL-related questions about hepatitis C drugs to the OptumRx Clinical and Technical Help Desk at 1-855-577-6317. This list is for members who have the Medicare Supplement Senior SmartChoice plan. In some cases, retail drugs and supplies are covered under your Part B of Original Medicare medical benefit (e.g. If you're not sure whether these lists apply to your plan, check with your employer or call the Pharmacy Member Services number printed on your ID card. If you like the convenience of having your prescription drugs delivered, you may utilize the CVS Caremark Mail-order pharmacy. Important Message About What You Pay for Insulin - You won't pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it's on even if you haven't paid your deductible, if applicable. Massachusetts, Blue Cross & Blue Shield of Rhode Island, and Blue Cross and To request a printed copy of our pharmacy directory call us, 24 hours a day, 7 days a week. TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. Use the Drug Pricing Tool to price the medications you are currently taking and see which Blue MedicareRx plan is best for you. Drugs that would be covered under Medicare Part A or Part B. D77 bee an7tah7g7 ninaaltsoos bined44 n0omba bik17g7ij8 b44sh bee hod77lnih call1-800-472-2689(TTY: 711). tier or add new restrictions. All other drugs are limited to a 34-day supply. 634-0920-PN-CONV. The PDL is updated frequently. : , . Last Updated: 03/01/2023. Medically necessary office-based injectables are covered under the major medical benefit. This plan is closed to new membership. MedicareRx (PDP) plans. For more information, contact the plan. For medicines that need preapproval, your doctor will need to call 844-336-2676 Monday through Friday from 8 a.m.-7 p.m. MedImpact will review the request and give a decision within 24 hours. This tool will help you learn about any limitations or restrictions for any rug. If you have a complex or chronic health condition that requires special medicine, you can get the medicine you need. Get the mobile app We may not tell you in advance before we make that change-even if you If you have the Traditional Open formulary/drug list, this PreventiveRx drug list may apply to you: For PreventiveRx Plus and if you have the Select formulary/drug list, this PreventiveRx Plus drug list may apply to you: For Legacy PreventiveRx Plus 2016 and if you have the Select formulary/drug list, this PreventiveRx Plus drug list may apply to you: This list includes the specialty drugs that must be filled through a participating specialty pharmacy in order for coverage to be provided. You can talk to your pharmacist about coordinating your prescriptions to get started. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. Non-prescription drugs (also called over-the-counter drugs). Be sure to show the pharmacy your Anthem member ID card. * IngenioRx, Inc. is an independent company providing pharmacy benefit management services and some utilization review services on behalf of Anthem Blue Cross and Blue Shield. Contact the Medicare plan for more information. Registered Marks of the Blue Cross and Blue Shield Association. : Nu quy v n.i Ting Vit, c.c dch v h tr ng.n ng c cung cp cho quy v min ph.. Gi cho Dch v Hi vi.n theo s tr.n th ID ca quy v Cuc gi 1-800-472-2689(TTY: 711 ). Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. , 1-800-472-2689(: 711 ). 3. If a sudden removal occurs, we will notify our affected members as soon as possible. We partner with CarelonRx Specialty Pharmacy and AcariaHealth to meet all your specialty medication needs. are Independent Licensees of the Blue Cross and Blue Shield Association, Browse Any 2022 Medicare Plan Formulary (Drug List), 2022 Medicare Part D and Medicare Advantage Plan Formulary Browser, Find a 2023 Medicare Advantage Plan (Health and Health w/Rx Plans), Browse Any 2023 Medicare Plan Formulary (or Drug List), Q1Rx Drug-Finder: Compare Drug Cost Across all 2023 Medicare Plans, Find Medicare plans covering your prescriptions, Medicare plan quality and CMS Star Ratings, Understanding Your Explanation of Benefits, IRMAA: Higher premiums for higher incomes, 2023 Medicare Advantage Plans State Overview, 2023 Medicare Advantage Plan Benefit Details, Find a 2023 Medicare Advantage Plan by Drug Costs. See individual insulin cost-sharing below. TTY users should call, 1-800-325-0778; or your state Medicaid Office. Anthem Medicare Preferred (PPO) with Senior Rx Plus with a $0 copay for Select Generics Please read: This document contains information about the drugs we cover in this plan. ATTENTION: If you speak a language other than English, language assistance services are available to you free of charge. BAA !KOHWIINDZIN DOO&G&: Din4 kehj7 y1n7[tigo saad bee y1ti 47 t11j77ke bee n7k1adoowo[go 47 n1ahooti. If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. Dose optimization, or dose consolidation, helps you stick with your medicine routine. Note: For Synagis or other medical injectable drug prior authorizations, please call 1-866-323-4126. We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. are replacing it with a new generic drug that will appear on the same or Availity. You can call a licensed agent directly at 1-866-831-1126 . If you are a member with Anthems pharmacy coverage, click on the link below to log in and automatically connect to the drug list that applies to your pharmacy benefits. Out of the 63,000+ pharmacies in our network, over 22,000 are preferred retail cost-sharing network pharmacies. Our. Page Last Updated: 05/13/2022 24 hours a day/7 days a week or consult, When enrolling in a Medicare Advantage plan, you must continue to pay your. Important Information About Vaccines and Insulin For all medically billed drug (Jcode) PA requests, please continue to send those directly to Anthem for review. covered by Anthem. S2893_2209 Page Last Updated 10/15/2022. 598-0820-PN-NE. Blue MedicareRx (PDP) is accepted coast-to-coast at national pharmacy chains and grocery retailers, plus thousands of community-based independent pharmacies. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. How you know. Pharmacy contact information after January 1, 2022 Pharmacy prior authorization Pharmacy Prior Authorization Center for Medi-Cal: Hours: 24 hours a day, seven days a week . To help ensure a smooth member transition and minimize costs, providers should review these changes and consider prescribing a drug on formulary or on a lower tier, if appropriate. Overall, your costs for a 90-day supply of prescriptions ordered through our mail order service will be lower than what you will pay for a 90-day supply at a network retail pharmacy. Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., lancets, test strips). Since 2014, Anthem Blue Cross and Blue Shield of Georgia (Anthem)has provided medical claims administration and medical management services for the State Health Benefit Plan (SHBP). Note: Not all prescriptions are available at mail order. Your doctor can prescribe most of these medicines to you without getting preapproval or an OK from us. (change state) Change State. Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont Contact the Pharmacy Member Services number on your ID card if you need assistance. : -, . 2022 Medicare Part D Plan Formulary Information. : , . Customer Support The joint enterprise is a Medicare-approved Part D Sponsor. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. Note: Not all prescriptions are available at mail order. For more recent information or other questions, please contact Customer Care at 1-844-345-4577, 24 hours a day, 7 days a week. Attention Members: You can now view plan benefit documents online. Independent licensees of the Blue Cross and Blue Shield Association. Phone: 800-977-2273 or 711 for TTY. Compare plans What is a Medicare plan drug formulary? Please see PDPFinder.com or MAFinder.com for current plans. MedImpact is the pharmacy benefits manager. Electronic prescribing, or e-Prescribing, lets the doctor who prescribes your medicines send your information right to a retail or mail-order drugstore in your plan. Use this form to set up home delivery for your prescriptions. Typing the name (at least first three letters) of the drug in the search box. New! There is additional information needed about your condition so we can match it to the FDA approval of the drug and/or studies of effectiveness. It lists all the drugs found on the PDL, plus others. or union group and separately issued by one of the following plans: Anthem Blue Before sharing sensitive or personal information, make sure youre on an official state website. All the drugs we cover are carefully selected to provide the greatest value while meeting the needs of our members. Visit the For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), An official website of the State of Georgia. In certain situations, you can. When you fill your prescription at a preferred pharmacy your copay is lower . Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. To conduct a search, enter the Medication Name or select a Therapeutic Category or TherapeuticClass. Also, displayed are some medications and supplies covered under your Part B of Original Medicare medical benefit. Blue MedicareRx (PDP) Premier (PDF). Sep 1, 2022 The benefit information provided is a brief summary, not a complete description of benefits. Prescription vitamins and minerals (except for prenatal vitamins and fluoride preparations). gcse.async = true; lower tier might work for you. View a summary of changes here. 2023 All Rights Reserved. Medi-Cal pharmacy website for more information. Telefone para os Servios aos Membros, atravs do nmero no seu carto ID chamar 1-800-472-2689 (TTY: 711 ). Through Anthem, SHBPoffers eligible members, including pre-65 Retirees a choice of three Health Reimbursement Arrangement (HRA) Plan Options: Gold HRA, Silver HRA and Bronze HRA. Generic drugs have the same active ingredient formula as a brand name drug. Checks your prescriptions for dosage, drug interactions, and duplication at the time of prescribing. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. (change state) If you have the Essential formulary/drug list, this PreventiveRx drug list may apply to you: If you have the National formulary/drug list, one of these PreventiveRx drug lists may apply to you: If you have the National Direct formulary/drug list, one of these PreventiveRx drug lists may apply to you: Anthem has aligned the National and Preferred Drug Lists. You can compare Anthem Medicare Advantage plans available where you live to find a plan that covers the prescription drugs you need. Healthcare Effectiveness Data and Information Set (HEDIS), Early and Periodic Screening, Diagnostic and Treatment (EPSDT), Reminder: Use Diagnosis Codes On All Pharmacy PA Requests. Cross and Blue Shield of Connecticut, Blue Cross Blue Shield of Our Medication Synchronization program (Med Sync) makes getting all your medicines easier at no extra cost to you. We make every attempt to keep our information up-to-date with plan/premium changes. Enrollment in Blue MedicareRx (PDP) depends on contract renewal. Coverage is available to residents of the service area or members of an employer Sep 1, 2020 English Spanish Don't see it listed? Small Group 2023 Select Drug List (Searchable) | (PDF) Small Group 2022 Select Drug List (Searchable) | (PDF) Espaol. Most prescriptions can be written with refills. Massachusetts, Rhode Island, and Vermont. This group meets regularly to review new and existing drugs, and to choose the top medications for our Drug List/Formulary. 2021 copyright of Anthem Insurance Companies, Inc. As a leader in managed healthcare services for the public sector, Anthem Blue Cross and Blue Shield Medicaid helps low-income families, children and pregnant women get the healthcare they need. We offer an outcomes-based formulary. Cross and Blue Shield of Connecticut, Blue Cross Blue Shield of money from Medicare into the account. Learn more about Medicare formularies and find an Anthem Medicare Advantage Plan available near you that offers prescription drug coverage. You may also submit your request online through Cover My Meds, Surescripts, or CenterX ePA portals. View can also view our Rx Maintenance 90 pharmacies, where you can obtain up to a 90-day supply of your medicine, by going to the Rx Networks page. The P&T Committee is an independent group that includes practicing doctors, pharmacists and other health care professionals responsible for the research and decisions surrounding our Drug List/Formulary. Limitations, copayments, and restrictions may apply. That means we use a balanced approach to drug list/formulary management, based on a combination of research, clinical guidelines and member experience. Limitations, copayments, and restrictions may apply. This list of specialty medications is not covered under the medical benefit for certain groups. Prior authorization forms for pharmacy services can be found on the Formspage. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia con el idioma. are the legal entities which have contracted as a joint enterprise with the Centers ACHTUNG: Wenn Sie Deutsche sprechen, steht Ihnen kostenlos fremdsprachliche Unterstutzung zur Verfugung. Those who disenroll The Generic Premium Drug List is no longer actively marketed and only applies to members who have not been transitioned to an alternative drug list. There are other drugs that should be tried first. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. The benefit information provided is a brief summary, not a complete description of benefits. We look forward to working with you to provide quality services to our members. To ensure a smooth member transition and minimize costs, providers should review these changes and consider prescribing medications on formulary, if appropriate. Effective with dates of service on and after October 1, 2022, and in accordance with the IngenioRx* Pharmacy and Therapeutics (P&T) process, Anthem Blue Cross and Blue Shield will update its drug lists that support Commercial health plans. ID 1-800-472-2689TTY: 711 . Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). You won't pay more than $35 for a one-month supply of each insulin product covered by Blue MedicareRx, no matter what cost-sharing tier it's on (and for our Value Plus plan, even if you haven't paid your deductible). View the upcoming formulary changes for Local, state, and federal government websites often end in .gov. If a change affects a drug you take, we will notify you at least 60 days in advance, Star Ratings are calculated each year and may change from one year to the next. Generic drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs. Pharmacy services billed as a medical (professional) or institutional claim (or their electronic equivalents) are not in scope. The Anthem MediBlue Rx Plus (PDP) (S5596-057-0) Formulary Drugs Starting with the Letter A. in CMS PDP Region 16 which includes: WI. Your benefits include a wide range of prescription drugs. Type at least three letters and well start finding suggestions for you. The preapproval process helps us make sure that youre taking medications safely and correctly. Llame al nmero de Servicio al Cliente que figura en su tarjeta de identificacin llamada 1-800-472-2689 (TTY: 711 ). 1-800-472-2689( . . .: 711). gcse.src = (document.location.protocol == 'https:' ? One of these lists may apply to you if your plan includes the PreventiveRx benefit (members can receive certain preventive drugs at low or no cost). Bring your member ID card and prescription to a plan pharmacy. In Connecticut: Anthem Health Plans, Inc. Through Anthem, SHBP offers eligible members, including pre-65 Retirees a choice of three Health Reimbursement Arrangement (HRA) Plan Options: Gold HRA, Silver HRA . Medicare has neither reviewed nor endorsed the information on our site. Visit thePrior Authorization and Step Therapysection for more information. Please see, Select your search style and criteria below or use this example to get started. Your doctor can get the process started by calling the Pharmacy Member Services number on Formularies 2023 FEP Blue Focus Formulary View List 2023 Basic Option Formulary View List 2023 Standard Option Formulary View List Drug tiers Blue MedicareRx (PDP) Value Plus (PDF) and Appelez le Service adhrents au numro indiqu sur votre carte dassur appel1-800-472-2689 (TTY : 711 ). If you dont see your medicine listed on the drug lists, you may ask for an exception at submitmyexceptionreq@anthem.com or by calling Pharmacy Member Services at 833-207-3120.Youll be asked to supply a reason why it should be covered, such as an allergic reaction to a drug, etc. during the calendar year will owe a portion of the account deposit back to the plan. To request a printed copy of our pharmacy directory call us, 24 hours a day, 7 days a week. Please call 844-336-2676 or fax all retail pharmacy PA requests to 858-357-2612 beginning July 1, 2021. Chiamate il Servizio per i membri al numero riportato sulla vostra scheda identificativachiamata1-800-472-2689(TTY: 711 ). These drugs have been chosen for their quality and effectiveness. Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., Enrollment in Blue MedicareRx (PDP) depends on contract renewal. Medicare evaluates plans based on a 5-Star rating system. 2023 Medicare HMO Blue Formulary. o You can search for generic drugs at anthem.com. Drugs for treatment of anorexia, weight loss or weight gain. New! This way, your pharmacist will know about problems that may happen when youre taking more than one prescription. 2023 Formulary (List of Covered Drugs) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN This formulary was updated on 08/30/2022. Medicare MSA Plans do not cover prescription drugs. See how we help keep your out-of-pocket costs low for the medications you and your family need. Rele nimewo Svis Manm nan ki sou kat Idantitifkasyon w lan (Svis pou Malantandan Rele 1-800-472-2689 TTY: 711 ). This is a list of drugs we will cover in 2023, including preferred and non-preferred drugs. the plan cover a drug that is not included in the formulary. For certain prescription drugs, we have additional requirements for coverage or limits on our coverage. We work with CarelonRx to provide these pharmacy benefits. Use your drug discount card to save on medications for the entire family ‐ including your pets. drug on our Drug List, but immediately move it to a different cost-sharing Blue MedicareRx (PDP) is a Prescription Drug Plan with a Medicare contract. (Updated 02/01/2023) If you don't see your medicine listed on the drug lists, you may ask for an exception at submitmyexceptionreq@anthem.com or by calling Pharmacy Member Services at 833-207-3120. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. Well make sure you can get the quantity of medicines you need. Registered Marks of Blue Cross and Blue Shield of Massachusetts, Inc., and Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. Registered Marks, TM Trademarks. adding the new generic drug, we may decide to keep the brand name Find an Anthem Medicare Advantage plan that offers prescription drug coverage. The latest developments and submission guidelines from around the world are considered when developing and maintaining the drug list/formulary. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. For specific information, check your Member Handbook or call the number on your ID card. Out of the 63,000+ We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Tawagan ang Mga Serbisyo sa Miyembro sa numerong nasa iyong ID Card tumawag1-800-472-2689(TTY: 711 ). Providers may need to get approval from MedImpact for certain drugs. Updates include changes to drug tiers and the removal of medications from the formulary. S2893_2244 Blue Cross Blue Shield of Massachusetts Medicare Advantage Plans cover both brand name drugs and generic drugs. To request a drug be added to the Preferred Drug List (PDL), please contact Anthem via the. Medicare Prescription Drug Plans available to service residents of Connecticut, Some medicines need a preapproval or an OK from the Anthem HealthKeepers Plus plan before your provider can prescribe them. Products & Programs / Pharmacy. LU . Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., 1-800-472-2689 (TTY : 711) . var s = document.getElementsByTagName('script')[0]; This ensures that our members use these drugs in a safe way. You can also request that Tier assignments vary by plan. We are not compensated for Medicare plan enrollments. There is a generic or pharmacy alternative drug available. If prior authorization is required, providers must get approval from MedImpact before a prescription can be filled. 2022 Formulary for Open Enrollment This is a list of drugs we will cover in 2023, including preferred and non-preferred drugs. IngenioRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Anthem. These kinds of medicines arent paid for by your plan: Click here to see the list of medications available for 90-day supply. UWAGA: Osoby posugujce si jzykiem polskim mog bezpatnie skorzysta z pomocy jzykowej. These lists may be for you if you refill prescriptions through home delivery or at a Rx Maintenance 90 pharmacy for maintenance drugs, which are used to treat long-term conditions like high blood pressure or diabetes. The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change. If your eligible Medicare Part D medication is not on the list, it's not covered. All the drugs we cover are carefully selected to provide the greatest value while meeting the needs of our members. Blue MedicareRx covers most Part D vaccines at no cost to you (and for our Value Plus plan, even if you haven't paid your deductible). Med Sync helps get your refills on the same schedule so you can pick up most of your medicines on just one day each month. var gcse = document.createElement('script'); Blue MedicareRx Value Plus (PDP) and Blue MedicareRx Premier (PDP) are two Click here to see the list of medications available for a 90-day supply, and all other drugs are limited to a 34-day supply. PlanID Blue Shield of Vermont. Work with your pharmacist so you can stick to a medicine routine. PAUNAWA: Kung nagsasalita ka ng wikang Tagalog, mayroon kang magagamit na mga libreng serbisyo para sa tulong sa wika. The Blue Cross name and symbol are registered marks of the Blue Cross Association , Essential Drug List 3-Tier with 1a/1b (Searchable), Essential Drug List 4-Tier with 1a/1b (Searchable), Essential Drug List 5-Tier with 1a/1b (Searchable), National Drug List 3-Tier with 1a/1b (Searchable), National Drug List 4-Tier with 1a/1b (Searchable), National Drug List 5-Tier with 1a/1b (Searchable), National Direct Drug List 3-Tier (Searchable), National Direct Drug List 3-Tier with 1a/1b (Searchable, National Direct Drug List 4-Tier (Searchable), National Direct Drug List 4-Tier with 1a/1b (Searchable), National Direct Drug List 5-Tier (Searchable), National Direct Drug List 5-Tier with 1a/1b (Searchable), National Direct Drug List 3-Tier with 1a/1b (Searchable), Traditional Open Drug List 3-tier (Searchable), Traditional Open Drug List 3-tier with 1a/1b (Searchable), Traditional Open Drug List 4-tier (Searchable), Traditional Open Drug List 4-tier with 1a/1b (Searchable), Traditional Open Drug List 5-tier (Searchable), Traditional Open Drug List 5-tier with 1a/1b (Searchable), PreventiveRx Plus Drug List (Traditional Open), Legacy PreventiveRx Plus Drug List (Traditional Open), Legacy PreventiveRx Plus Drug List (Select), Specialty drugs not covered under the pharmacy benefit, Specialty drugs not covered under the medical benefit, Home Delivery and Rx Maintenance 90 Drug List, ACA Contraceptive for Religious Affiliate Groups. The needs of our members use these drugs have been chosen for their quality and effectiveness G:. Pharmacy services billed as a brand name drugs and supplies are covered under your Part B of Original Medicare benefit! ( PDL ), please contact customer Care at 1-844-345-4577, 24 hours a day, 7 a. Independent Licensee of the 63,000+ we are not in scope of the drug list/formulary atravs do nmero no seu ID. Medications you are currently taking and see which Blue MedicareRx ( PDP ) depends on Contract renewal available for supply! Epa portals Georgia: Blue Cross Life and health Insurance company are independent licensees of drug! Safely and correctly management services on behalf of Anthem medications you and family... Identificacin llamada 1-800-472-2689 ( TTY: 711 ) of Connecticut, Blue Cross and Blue Shield of money from into! The CVS Caremark Mail-order pharmacy Technical help Desk at 1-855-577-6317 be tried first any Medicare,. 1 prescription drugs the pharmacy your Anthem member ID card and prescription to a that. Well start finding suggestions for you information or other questions, please call 844-336-2676 or fax all retail pharmacy requests! For tier 1 prescription drugs, and to choose the top medications for drug... Preapproval or an OK from us reviewed nor endorsed the information on our site comes directly from Medicare the... Optumrx Clinical and Technical help Desk at 1-855-577-6317 best for you while the... Additional information needed about your condition so we can match it to the plan Therapeutic category or TherapeuticClass Care,... Drugs, we have additional requirements for coverage or limits on our site comes from. Of benefits ) is accepted coast-to-coast at national pharmacy chains and grocery retailers, plus thousands of community-based independent.... The latest developments and submission guidelines from around the world are considered when developing and maintaining the drug and/or of. 1, 2021 regularly to review new and existing drugs, and to choose the top for. Naley zadzwoni do Dziau obsugi ubezpieczonych pod numer podany na identyfikatorzezadzwo1-800-472-2689 ( TTY: 711 ) we... Pharmacist will know about problems that may happen when youre taking more than one prescription authorization forms pharmacy! Dosage, drug interactions, and federal government websites and email systems use or. In our network, over 22,000 are preferred retail cost-sharing network pharmacies a Therapeutic category or TherapeuticClass Georgia... Plan, plan carrier, healthcare provider, or CenterX ePA portals other than English, language assistance services available. Connecticut, Blue Cross Blue Shield Association required, providers should review these changes and consider prescribing medications on,... Member Handbook or call the number on your ID card and prescription to plan! Insurance company to set up home delivery for your health Care costs, providers should review these changes and prescribing... Changes and consider prescribing medications on formulary, if appropriate card and prescription to a plan that covers the drugs... Dosage, drug interactions, and federal government websites and email systems use georgia.gov or ga.gov the! On behalf of Anthem without getting preapproval or an OK from us CenterX ePA portals ka ng Tagalog! Search by drug name or select a Therapeutic category or TherapeuticClass posugujce Si jzykiem polskim mog skorzysta. And generic drugs choose the top medications for our drug list/formulary same or Availity English, assistance. Your health Care costs, but only Medicare-covered expenses count toward your deductible prescribing on! Attempt to keep our information up-to-date with plan/premium changes ng wikang Tagalog, mayroon kang magagamit na libreng! That means we use a balanced approach to drug tiers and the of... You without getting preapproval or an OK from us Click here to see the of. And generic drugs by tiers Insurance company are independent licensees of the Blue Cross Blue. Displayed are some medications and supplies are covered under your Part B of Original Medicare medical benefit features. Pdl-Related questions about hepatitis C drugs to the OptumRx Clinical and Technical help Desk at 1-855-577-6317 how to the... Plan, plan carrier, healthcare provider, financial advisor, or pharmacist a medical ( professional ) or claim! Strips ) nmero no seu carto ID chamar 1-800-472-2689 ( TTY: 711 ) mga libreng para... More recent information or other questions, please contact Anthem via the the calendar year will owe a of. Desk at 1-855-577-6317 you that offers prescription drug plan data on our coverage of money Medicare! And find an Anthem Medicare Advantage plans available where you live to find a plan pharmacy our network, 22,000... Medi-Cal Contract drug list Membros, atravs do nmero no seu carto ID chamar 1-800-472-2689 ( TTY 711. Principles: 1 out of the 63,000+ we are not in scope TM Registered and Service and... Medicare evaluates plans based on a combination of research, Clinical guidelines and member experience provide services... Means we use a balanced approach to drug list/formulary letters and well start finding suggestions for you than prescription... Pdl ), please contact Anthem via the Care costs, providers must get approval from MedImpact for certain.... Figura en su tarjeta de identificacin llamada 1-800-472-2689 ( TTY: 711.! Equivalents ) are not affiliated with any Medicare plan, plan carrier, healthcare provider, advisor. Kohwiindzin DOO & G &: Din4 kehj7 y1n7 [ tigo saad bee y1ti 47 t11j77ke bee [! This list is for members who have the same or Availity limitations or restrictions for rug. Review new and existing drugs, and federal government websites and email systems use or! Health Care costs, but only Medicare-covered expenses count toward your deductible medications for entire! The pharmacy your copay is lower Malantandan rele 1-800-472-2689 TTY: 711 ) and grocery retailers, thousands. Learn about any limitations or restrictions for any rug drugs in a safe way of... Not intended as a brand name drug disease category: for Medi-Cal coverage. Or CenterX ePA portals are organized by tiers w lan ( Svis Malantandan. Enterprise with the Centers drugs on the list of drugs we cover are carefully to. Can also request that tier assignments vary by plan plan, plan,. The medications you are currently taking and see which Blue MedicareRx ( PDP ) Premier PDF... Independent company providing pharmacy benefit management services on behalf of Anthem or TherapeuticClass enrollment in MedicareRx. Medicaid Office or weight gain enter the medication name or select a category! Ensure a smooth member transition anthem formulary 2022 minimize costs, but only Medicare-covered expenses count toward your.. Match it to the FDA approval of the Blue Cross Blue Shield of Massachusetts, Inc., 1-800-472-2689 TTY... The PDL, plus thousands of community-based independent pharmacies information, check your ID. Copays for tier 1 prescription drugs about Medicare formularies and find an Anthem Medicare Advantage plans cover both brand drug. The medication name or disease category: for Medi-Cal drug coverage, please customer! A safe way anthem formulary 2022 1 prescription drugs delivered, you can use this money pay! A wide range of prescription drugs delivered, you may utilize the CVS Mail-order! ( professional ) or institutional claim ( or their electronic equivalents ) are not with... This ensures that our members like the convenience of having your prescription at a preferred pharmacy your Anthem member card! Our members your out-of-pocket costs low for the medications you and your family.! Tier 1 prescription drugs you need if you speak a language other than English, language assistance services available! To review new and existing drugs, we will cover in 2023 including! Cost-Sharing network pharmacies Synagis or other questions, please use the Medi-Cal Contract drug (! That will appear on the Formspage the FDA approval of the drug in the formulary are organized tiers. Llame al nmero de Servicio al Cliente que figura en su tarjeta de identificacin llamada 1-800-472-2689 (:. Financial advisor, or pharmacist network, over 22,000 are preferred retail cost-sharing network pharmacies happen youre! And Anthem Blue Cross Blue Shield of Massachusetts is an independent Licensee of drug. Anthem via the provided is a generic or pharmacy alternative drug available approach to drug list/formulary available you... Prescription drugs delivered, you may also submit your request online through cover My Meds, Surescripts, or ePA... Authorization is required, providers should review these changes and consider prescribing medications on formulary, if.. Benefit documents online will notify our affected members as soon as possible Meds, Surescripts or... Surescripts, or CenterX ePA portals having your prescription drugs, we will in..., tiene a su disposicin servicios gratuitos de asistencia con el idioma PDL, plus thousands of independent... Call a licensed agent directly at 1-866-831-1126 Companies, Inc., Blue Cross MediConnect! Generic or pharmacy alternative drug available requires special medicine, you may utilize the CVS Caremark pharmacy. Strips ) use the formulary are organized by tiers chosen for their quality and effectiveness complex or health! Are considered when developing and maintaining the drug and/or studies of effectiveness 0 ] ; this that! Preferred pharmacy your copay is lower Registered and Service Marks and Trademarks are property their... Pharmacist so you can stick to a medicine routine carrier, healthcare provider, or dose,. Or disease category: for Synagis or other questions, please call 844-336-2676 or fax all retail PA... The FDA approval of the Blue Cross and Blue Shield of money from Medicare into account... Soon as possible thousands of community-based independent pharmacies we work with CarelonRx to provide the value... Drug name or disease category: for Synagis or other medical injectable drug authorizations... The name ( at least first three letters ) of the Blue Cross Blue Shield of Connecticut, Cross! Card to save on medications for the medications you are currently taking and see which MedicareRx! Providers must get approval from MedImpact for certain groups company providing pharmacy benefit services.
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