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. SM, TM Registered and Service Marks and Trademarks are property of their respective owners. Members may enroll in a Medicare Advantage plan only during specific times of the year. var s = document.getElementsByTagName('script')[0]; The Blue Cross name and symbol are registered marks of the Blue Cross Association. (change state) View the upcoming formulary changes for New! Rufen Sie den Mitgliederdienst unter der Nummer auf Ihrer ID-Karte an Anrufen1-800-472-2689(TTY: 711 ). 1-800-472-2689(TTY: 711). In Connecticut: Anthem Health Plans, Inc. If you like the convenience of having your prescription drugs delivered, you may utilize the CVS Caremark Mail-order pharmacy. To verify Medi-Cal pharmacy network participation or pharmacy drug coverage under Medi-Cal, please call the Pharmacy Benefits Manager: The Anthem Blue Cross Cal MediConnect Plan Formulary lists the brand name or generic name of a given drug. 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. If a change affects a drug you take, we will notify you at least 60 days in advance, ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Please note: The above plan information comes from CMS. Contact Anthem Blue Cross and Blue Shield. 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. That means we use a balanced approach to drug list/formulary management, based on a combination of research, clinical guidelines and member experience. Click on your plan to find a network pharmacy near your home or wherever you travel. Please note, this update does not apply to the Select Drug List and does not impact Medicaid and Medicare plans. Before sharing sensitive or personal information, make sure youre on an official state website. You, your prescribing doctor, and a pharmacist work together to replace multiple doses of lower-strength medications with one dose of a higher-strength medication. for Medicare & Medicaid Services (CMS) and are the risk-bearing entities for Blue gcse.src = (document.location.protocol == 'https:' ? Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., IngenioRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Anthem. Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont 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. Off-label drug use, which means using a drug for treatments not specifically mentioned on the drugs label. Use of the Anthem websites constitutes your agreement with our Terms of Use. OTC drugs aren't shown on the list. , 1-800-472-2689(: 711 ). Some medicines need a preapproval or an OK from the Anthem HealthKeepers Plus plan before your provider can prescribe them. 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). 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. The Anthem MediBlue Rx Plus (PDP) (S5596-057-0) Formulary Drugs Starting with the Letter A. in CMS PDP Region 16 which includes: WI. Drugs not approved by the U.S. Food and Drug Administration (FDA). Use your drug discount card to save on medications for the entire family ‐ including your pets. PAUNAWA: Kung nagsasalita ka ng wikang Tagalog, mayroon kang magagamit na mga libreng serbisyo para sa tulong sa wika. Llame al nmero de Servicio al Cliente que figura en su tarjeta de identificacin llamada 1-800-472-2689 (TTY: 711 ). PlanID Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Saves you time by speeding up the medicine refill process. Out of the 63,000+ pharmacies in our network, over 22,000 are preferred retail cost-sharing network pharmacies. To submit electronic prior authorization (ePA) requests online, use Blue Cross of California is contracted with L.A. Care Health Plan to provide Medi-Cal Managed Care services in Los Angeles County. or union group and separately issued by one of the following plans: Anthem Blue 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). Here are some reasons that preapproval may be needed: For medicines that need preapproval, your provider will need to call Provider Services. We make receiving prescriptions as convenient as possible. If you dont have Adobe Acrobat Reader, you can download a free copy by clicking HERE. 2021 Blue Cross and Blue Shield of Massachusetts, Inc., or Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. April 1 through September 30, 8:00 a.m. to 8:00 p.m. There are certain types of drugs that Blue MedicareRx cannot include in the formulary due to federal law, including: In addition, a Medicare Part D plan cannot cover: Blue MedicareRx (PDP) is a Prescription Drug Plan with a Medicare contract. March 2023 Anthem Blue Cross Provider News - California, Action required: 2023 Consumer Grievance and Appeals attestation Requirement, Group number change for Screen Actors Guild-American Federation of Television and Radio Artists Health Plan, February 2023 Anthem Blue Cross Provider News - California, January 2023 Anthem Blue Cross Provider News - California, September 2020 Anthem Blue Cross Provider News - California. Products & Programs / Pharmacy. 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. Enrollment in Blue MedicareRx (PDP) depends on contract renewal. We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield Medicaid. If a sudden removal occurs, we will notify our affected members as soon as possible. you and/or your doctor must request a coverage determination before the plan will cover your drug. 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. This list only applies if you have a specialty pharmacy network included in your benefit. * 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. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. For more recent information or other questions, please contact Customer Care at 1-844-345-4577, 24 hours a day, 7 days a week. are the legal entities which have contracted as a joint enterprise with the Centers The Blue Cross and Blue Shield of Illinois (BCBSIL) Prescription Drug List (also known as a Formulary) is designed to serve as a reference guide to pharmaceutical products. Massachusetts, Rhode Island, and Vermont. Anthem Blue Cross is the trade name of Blue Cross of California. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. We do not sell leads or share your personal information. Blue MedicareRx (PDP) Value Plus (PDF) and Sep 1, 2022 ZIP & Plan 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. 634-0920-PN-CONV. are Independent Licensees of the Blue Cross and Blue Shield Association, 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. Those who disenroll 598-0820-PN-NE. If youre interested in saving money on your prescriptions, discuss with your doctor whether switching to a similar drug on a If prior authorization is required, providers must get approval from MedImpact before a prescription can be filled. Products & Programs / Pharmacy. You may also submit your request online through Cover My Meds, Surescripts, or CenterX ePA portals. TTY 711 Also, displayed are some medications and supplies covered under your Part B of Original Medicare medical benefit. Deductible as low as $350 $1 - $5 copays for most generic drugs at preferred pharmacies Select list of covered drugs Mail-order delivery for eligible prescriptions Your doctor can get the process started by calling the Pharmacy Member Services number on Independent licensees of the Blue Cross and Blue Shield Association. Anthem MediBlue Rx Plus (PDP) (S5596-057-0) Benefit Details. '//cse.google.com/cse.js?cx=' + cx; Tier assignments vary by plan. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. Non-prescription drugs (also called over-the-counter drugs). 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. Select your search style and criteria below or use this example to get started The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Drugs for treatment of sexual or erectile dysfunction (ED). This group meets regularly to review new and existing drugs, and to choose the top medications for our Drug List/Formulary. Providers who do not contract with the plan are not required to see you except in an emergency. We have two drug lists that show which drugs are in your plan. 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. Its easy when you use our search tool. Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., 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 have any questions about your pharmacy benefits, call Pharmacy Member Services at 1-833-207-3120 (TTY 711) 24 hours a day, seven days a week. There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. : , , : .. lower cost sharing tier and with the same or fewer restrictions. PDP-Compare: How will each 2021 Part D Plan Change in 2022? Dietary supplements, except for treatment of phenylketonuria (PKU). Use of the Anthem Web sites constitutes your agreement with our Terms of Use. s.parentNode.insertBefore(gcse, s); adding the new generic drug, we may decide to keep the brand name We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. are the legal entities which have contracted as a joint enterprise with the Centers The formulary is a list of all brand-name and generic drugs available in your plan. Type at least three letters and well start finding suggestions for you. Medically necessary office-based injectables are covered under the major medical benefit. Your doctor can prescribe most of these medicines to you without getting preapproval or an OK from us. Blue MedicareRx (PDP) is accepted coast-to-coast at national pharmacy chains and grocery retailers, plus thousands of community-based independent pharmacies. Copy by clicking here: the above plan information comes from CMS Original Medicare medical benefit, but only expenses. Money to pay for your lawyer, doctor, healthcare provider, financial advisor, or ePA... Blue gcse.src = ( document.location.protocol == 'https: ' is a Registered of! Your deductible an independent company providing administrative support Services on behalf of Anthem Insurance Companies, we! Affected members as soon as possible can download a free copy by clicking here contract the! Well start finding suggestions for you Blue gcse.src = ( document.location.protocol ==:. Company providing administrative support Services on behalf of Anthem Insurance Companies, we. 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