ET, Monday through Friday. 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. All the drugs we cover are carefully selected to provide the greatest value while meeting the needs of our members. 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. Find an Anthem Medicare Advantage plan that offers prescription drug coverage. Benefits, formulary, pharmacy network, premium and/or copayments/co-insurance may change on January 1 of each year. are preferred retail cost-sharing network pharmacies. Get the mobile app The joint enterprise is a Medicare-approved Part D Sponsor. Use the Drug Pricing Tool to price the medications you are currently taking and see which Blue MedicareRx plan is best for you. Please note: The above plan information comes from CMS. covered by Anthem. Dose optimization, or dose consolidation, helps you stick with your medicine routine. gcse.async = true; 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. Customer Support tier or add new restrictions. 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. Out of the 63,000+ The Preferred Drug List (PDL) is the list of drugs that your doctor will use first when prescribing you medicine. This is known as prior authorization. You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Some medicines need a preapproval or an OK from the Anthem HealthKeepers Plus plan before your provider can prescribe them. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., Attention Members: You can now view plan benefit documents online. Also, displayed are some medications and supplies covered under your Part B of Original Medicare medical benefit. Contact the Pharmacy Member Services number on your ID card if you need assistance. Use your drug discount card to save on medications for the entire family ‐ including your pets. For all medically billed drug (Jcode) PA requests, please continue to send those directly to Anthem for review. How you know. We work with CarelonRx to provide these pharmacy benefits. If a sudden removal occurs, we will notify our affected members as soon as possible. This ensures that our members use these drugs in a safe way. Drugs that would be covered under Medicare Part A or Part B. Click on your plan to find a network pharmacy near your home or wherever you travel. Important Information About Vaccines and Insulin '//cse.google.com/cse.js?cx=' + cx; gcse.type = 'text/javascript'; 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). The formulary is a list of our covered prescription drugs, including generic, brand name and specialty drugs. TTY users should call 711. are the legal entities which have contracted as a joint enterprise with the Centers MA-Compare: Review Changes in each 2021 Medicare Advantage Plan for 2022, Find a 2022 Medicare Part D Plan (PDP-Finder: Rx Only), Find a 2022 Medicare Advantage Plan (Health and Health w/Rx Plans), Q1Rx 2022 Medicare Part D or Medicare Advantage Plan Finder by Drug, Guided Help Finding a 2022 Medicare Prescription Drug Plan, Search for 2022 Medicare Plans by Plan ID, Search for 2022 Medicare Plans by Formulary ID, 2022 Medicare Prescription Drug Plan (PDP) Benefit Details, 2022 Medicare Advantage Plan Benefit Details, Pre-2020 Medicare.gov Plan Finder Tutorial, Example: AARP MedicareRx Preferred (PDP) Formulary in Florida, Learn more about savings on Pet Medications, ABACAVIR-LAMIVUDINE 600-300 MG TABLET [Epzicom], ABIRATERONE ACETATE 250 MG TABLET [ZYTIGA], Acamprosate Calcium DR 333 MG tablets [Campral], ACETAMINOPHEN-COD #3 TABLET [Tylenol with Codeine No.3], ACETAZOLAMIDE ER 500 MG CAPSULE ER [Diamox Sequels], ACETYLCYSTEINE 20% VIAL [Mucosil Acetylcysteine], ADEFOVIR DIPIVOXIL 10 MG TABLET [Hepsera], ADVAIR HFA 230; 21ug/1; ug/1 120 AEROSOL, METERED in 1 INHALER, ADVAIR HFA INHALER 115;21MCG;MCG 120 ACTN INHL, ADVAIR HFA INHALER 45;21MCG;MCG 120 ACTN INHL, ALBUTEROL HFA 90 MCG INHALER HFA AER AD [Ventolin HFA], ALBUTEROL SUL 0.63 MG/3 ML SOLUTION VIAL-NEB [Accuneb], ALBUTEROL SUL 1.25 MG/3 ML SOLUTION VIAL-NEB, ALBUTEROL SUL 2.5 MG/3 ML SOLUTION VIAL-NEB, ALCLOMETASONE DIPR 0.05% OINTMENT [Aclovate], ALENDRONATE SOD 70 MG/75 ML SOLUTION [Fosamax], ALENDRONATE SODIUM 10 MG TABLET [Fosamax], ALENDRONATE SODIUM 35 MG TABLET [Fosamax], ALENDRONATE SODIUM 70 MG TABLET [Fosamax], AMILORIDE HCL-HCTZ 5-50 MG TABLET [Moduretic], Amino acids 4.25% in dextrose 10% Injectable Solution [Clinimix 4.25/10], Amino acids 4.25% in dextrose 5% Injectable Solution [Clinimix 4.25/5], AMLODIPINE BESYLATE 10 MG TABLET [Norvasc], AMLODIPINE BESYLATE 2.5 MG TABLET [Norvasc], AMLODIPINE BESYLATE 5 MG TABLET [Norvasc], AMLODIPINE-BENAZEPRIL 10-20 MG CAPSULE [Lotrel], AMLODIPINE-BENAZEPRIL 10-40 MG CAPSULE [Lotrel], AMLODIPINE-BENAZEPRIL 2.5-10 CAPSULE [Lotrel], AMLODIPINE-BENAZEPRIL 5-10 MG CAPSULE [Lotrel], AMLODIPINE-BENAZEPRIL 5-20 MG CAPSULE [Lotrel], AMLODIPINE-BENAZEPRIL 5-40 MG CAPSULE [Lotrel], AMLODIPINE-OLMESARTAN 10-20 MG TABLET [AZOR], AMLODIPINE-OLMESARTAN 10-40 MG TABLET [AZOR], AMLODIPINE-OLMESARTAN 5-20 MG TABLET [AZOR], AMLODIPINE-OLMESARTAN 5-40 MG TABLET [AZOR], AMLODIPINE-VALSARTAN 10-160 MG TABLET [Exforge], AMLODIPINE-VALSARTAN 10-320 MG TABLET [Exforge], AMLODIPINE-VALSARTAN 5-160 MG TABLET [Exforge], AMLODIPINE-VALSARTAN 5-320 MG TABLET [Exforge], AMMONIUM LACTATE 12% CREAM (g) [Lac-Hydrin], AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE [Augmentin], AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET [Augmentin], AMOX TR-POTASSIUM CLAVULANATE 400-57MG TABLET CHEWABLE [Augmentin], AMOX-CLAV 400-57 MG/5 ML ORAL SUSPENSION [Augmentin], AMOX-CLAV ER 1,000-62.5 MG TABLET [Augmentin], AMOXICILLIN 200 MG/5 ML ORAL SUSPENSION [Amoxil], AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION [Trimox], AMOXICILLIN 400 MG/5 ML ORAL SUSPENSION [Amoxil], Ampicillin 1000 MG / Sulbactam 500 MG Injection, Ampicillin 125mg/1 10 VIAL, GLASS in 1 PACKAGE / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS, Anagrelide Hydrochloride 0.5mg/1 100 CAPSULE BOTTLE, APOMORPHINE 30 MG/3 ML CARTRIDGE [Apokyn], Apraclonidine 5 MG/ML Ophthalmic Solution, ARIPIPRAZOLE ODT 10 MG TABLET RAPDIS [Abilify Discmelt], ARIPIPRAZOLE ODT 15 MG TABLET RAPDIS [Abilify Discmelt], ASENAPINE 10 MG SUBLIGUAL TABLET [Saphris], ASENAPINE 2.5 MG TABLET SUBLIGUAL [Saphris], ASENAPINE 5 MG SUBLIGUAL TABLET [Saphris], ASPIRIN-DIPYRIDAM ER 25-200 MG CPMP 12HR [Aggrenox], ATAZANAVIR SULFATE 150 MG CAPSULE [Reyataz], ATAZANAVIR SULFATE 200 MG CAPSULE [Reyataz], ATAZANAVIR SULFATE 300 MG CAPSULE [Reyataz], ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT), ATOMOXETINE HCL 10 MG CAPSULE [Strattera], ATOMOXETINE HCL 100 MG CAPSULE [Strattera], ATOMOXETINE HCL 18 MG CAPSULE [Strattera], ATOMOXETINE HCL 25 MG CAPSULE [Strattera], ATOMOXETINE HCL 40 MG CAPSULE [Strattera], ATOMOXETINE HCL 60 MG CAPSULE [Strattera], ATOMOXETINE HCL 80 MG CAPSULE [Strattera], ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION [Mepron], Atovaquone-Proguanil 250; 100mg/1; mg/1 [Malarone], AZITHROMYCIN 100 MG/5 ML ORAL SUSPENSION [Zithromax], AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION [Zithromax], AZITHROMYCIN 250 MG TABLET [Zithromax Z-Pak], AZITHROMYCIN 500 MG TABLET [Zithromax Tri-Pak], AZITHROMYCIN 600 MG TABLET [Zithromax Z-Pak], AZITHROMYCIN I.V. Important Message About What You Pay for Vaccines - Our plan covers most Part D vaccines at no cost to you, even if you havent paid your deductible (if applicable.) for Medicare & Medicaid Services (CMS) and are the risk-bearing entities for Blue Medicare has neither reviewed nor endorsed the information on our site. Drugs requiring the assistance of a medical professional (office-based injectables) are not covered under the pharmacy benefit. 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. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia con el idioma. Rufen Sie den Mitgliederdienst unter der Nummer auf Ihrer ID-Karte an Anrufen1-800-472-2689(TTY: 711 ). lancets, test strips). We offer an outcomes-based formulary. Llame al nmero de Servicio al Cliente que figura en su tarjeta de identificacin llamada 1-800-472-2689 (TTY: 711 ). Use the formulary to search by drug name or disease category: For Medi-Cal drug coverage, please use the Medi-Cal Contract Drug List. Off-label drug use, which means using a drug for treatments not specifically mentioned on the drugs label. Medicare evaluates plans based on a 5-Star rating system. Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont are the legal entities that have contracted as a joint enterprise with the Centers for Medicare & Medicaid Services (CMS) and are the risk-bearing entities for Blue MedicareRx (PDP) plans. : . A doctor can also call in the prescription for you. For more information, contact the plan. If a medication does not appear on this formulary, a prescription drug prior authorization form will need to be completed by the prescriber and submitted to Anthem Blue Cross (Anthem) before the prescription may be filled. : , , : .. Out of the 63,000+ pharmacies in our network, over 22,000 are preferred retail cost-sharing network pharmacies. In certain situations, you can. Blue Cross of California is contracted with L.A. Care Health Plan to provide Medi-Cal Managed Care services in Los Angeles County. That means we use a balanced approach to drug list/formulary management, based on a combination of research, clinical guidelines and member experience. Appelez le Service adhrents au numro indiqu sur votre carte dassur appel1-800-472-2689 (TTY : 711 ). Generic drugs have the same active ingredient formula as a brand name drug. Rele nimewo Svis Manm nan ki sou kat Idantitifkasyon w lan (Svis pou Malantandan Rele 1-800-472-2689 TTY: 711 ). . ID 1-800-472-2689TTY 711 ). Bring your member ID card and prescription to a plan pharmacy. View the upcoming formulary changes for 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). 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. 1-800-472-2689(TTY: 711) . If you use another pharmacy, you should tell the pharmacist about all medicines you are taking. Members may enroll in a Medicare Advantage plan only during specific times of the year. Prior authorization phone and fax numbers All prior authorizations will be managed by MedImpact. 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