The Blue Cross name and symbol are registered marks of the Blue Cross Association. For Medi-Cal: Call Customer Service at 800-977-2273. Your doctor can prescribe most of these medicines to you without getting preapproval or an OK from us. o If a drug you're taking isn't covered, your doctor can ask us to review the coverage. We make every attempt to keep our information up-to-date with plan/premium changes. Contact the Medicare plan for more information. Medicare Prescription Drug Plans available to service residents of Connecticut, To 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. For MRMIP and MMP: Prescriptions can be filled at more than 5,000 retail pharmacies in California and a listing of these pharmacies (pharmacy network) can be found in our provider directories. Blue MedicareRx (PDP) is a Prescription Drug Plan with a Medicare contract. 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. This plan covers select insulin pay $35 copay. We do not sell leads or share your personal information. (function() { They choose drugs for these lists based on a number of factors including how well they work, value to patients and safety. Here are some reasons that preapproval may be needed: For medicines that need preapproval, your provider will need to call Provider Services. Your prescribing doctor has to approve this change to make sure its appropriate for your care. These kinds of medicines arent paid for by your plan: Click here to see the list of medications available for 90-day supply. 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 (ID Card) 1-800-472-2689(TTY: 711 ). ATTENTION: If you speak a language other than English, language assistance services are available to you free of charge. Simply take your written prescription to a plan pharmacy or ask your doctor to call it in. 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). This plan is closed to new membership. 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. There may be some physician administered medical injectable drugs that require approval from Anthem before a prescription can be filled. Before sharing sensitive or personal information, make sure youre on an official state website. The joint enterprise is a Medicare-approved Part D Sponsor. Sep 1, 2022 The benefit information provided is a brief summary, not a complete description of benefits. : , . Last Updated: 03/01/2023. A doctor can also call in the prescription for you. The Preferred Drug List (PDL) is the list of drugs that your doctor will use first when prescribing you medicine. 500 MG VIAL [Zithromax], Everyone in your household can use the same card, including your pets. 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. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. This way, your pharmacist will know about problems that may happen when youre taking more than one prescription. 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. Prior authorization phone and fax numbers All prior authorizations will be managed by MedImpact. Important Information About Vaccines and Insulin Out of the 63,000+ pharmacies in our network, over 22,000 are preferred retail cost-sharing network pharmacies. This version of the Select Drug List applies to Individual plans if you purchased a plan on your state or federal Health Insurance Marketplace (also known as the exchange) or if you purchased coverage off the exchange and not through your employer: This version of the Select Drug List applies to Small Group plans if your coverage is through a Small Group employer on, and in some cases, off the exchange. 'https:' : 'http:') + 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. Blue MedicareRx Value Plus (PDP) and Blue MedicareRx Premier (PDP) are two 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). Individual 2022 Select Drug List (Searchable) | This version of the Select Drug List applies to Small Group plans if your coverage is through a Small Group employer on, and in some cases, off the exchange. Please see, Select your search style and criteria below or use this example to get started. Sep 1, 2020 Your benefits include a wide range of prescriptions and over-the-counter (OTC) medicines. In Georgia: Blue Cross Blue Shield Healthcare Plan of Georgia, Inc. S2893_2244 Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home. 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). D77 bee an7tah7g7 ninaaltsoos bined44 n0omba bik17g7ij8 b44sh bee hod77lnih call1-800-472-2689(TTY: 711). 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. during the calendar year will owe a portion of the account deposit back to the plan. Its easy when you use our search tool. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. 1-800-472-2689(TTY: 711) . You pay nothing for these drugs and supplies covered under your Original Medicare medical benefit. All prior authorizations will be managed by MedImpact. The PDL is updated frequently. Blue Cross Blue Shield of Massachusetts Medicare Advantage Plans cover both brand name drugs and generic drugs. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. To request a printed copy of our pharmacy directory call us, 24 hours a day, 7 days a week. 2022 Formulary for Open Enrollment This is a list of drugs we will cover in 2023, including preferred and non-preferred drugs. If you need your medicine right away, you may be able to get a 72-hour supply while you wait. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). The formulary is a list of our covered prescription drugs, including generic, brand name and specialty drugs. There are other drugs that should be tried first. ID 1-800-472-2689TTY: 711 . Pharmacy services billed as a medical (professional) or institutional claim (or their electronic equivalents) are not in scope. You may ask us to cover a Medicare Part D medication not listed on our formulary by requesting a formulary exception to waive coverage restrictions or limits on your medication. Your benefits include a wide range of prescription drugs. 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. Please call 844-336-2676 or fax all retail pharmacy PA requests to 858-357-2612 beginning July 1, 2021. Contact Anthem Blue Cross and Blue Shield. PlanID Change State. MedicareRx (PDP) plans. October 1 through March 31, 8:00 a.m. to 8:00 p.m. Naley zadzwoni do Dziau obsugi ubezpieczonych pod numer podany na identyfikatorzezadzwo1-800-472-2689(TTY: 711 ). Please refer to the Provider Manual for more details on medical coverage: We look forward to working with you to provide quality services to our members. Learn more about Blue Ticket to Health Get your flu shot Flu shots, pneumonia shots, FluMist TM and antiviral medications are approved benefits under most health plans. Anthem MediBlue Rx Plus (PDP) (S5596-057-0) Benefit Details. adding the new generic drug, we may decide to keep the brand name In Ohio: Community Insurance Company. You may also submit your request online through Cover My Meds, Surescripts, or CenterX ePA portals. View a summary of changes here. New! . HealthKeepers, Inc. is an independent licensee of the Blue Cross and Blue Shield Association. These medications and supplies are available at network retail pharmacies. This group meets regularly to review new and existing drugs, and to choose the top medications for our Drug List/Formulary. To 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. 2022 Medicare Part D Plan Formulary Information. 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. There is no pharmacy copay for Cardinal Care and FAMIS members.. For more recent information or other questions, please contact Customer Care at 1-844-345-4577, 24 hours a day, 7 days a week. To request a drug be added to the Preferred Drug List (PDL), please contact Anthem via the. The Pharmacy and Therapeutics (P&T) Committee picks drugs considered to be the top choices based on their safety, effectiveness and value for our Drug List/Formulary. You can also learn more about some of our online tools, like pricing a drug, by clicking on the link to the video. A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Do you want to look up your medicine and find out if it is covered in your plan? Bring your member ID card and prescription to a plan pharmacy. It is for a higher supply of medicine than our standard 34-day supply. Customer Support Chiamate il Servizio per i membri al numero riportato sulla vostra scheda identificativachiamata1-800-472-2689(TTY: 711 ). Contact the Pharmacy Member Services number on your ID card if you need assistance. (Updated 02/01/2023) To request a printed copy of our pharmacy directory call us, 24 hours a day, 7 days a week. Massachusetts, Rhode Island, and Vermont. When you fill your prescription Rufen Sie den Mitgliederdienst unter der Nummer auf Ihrer ID-Karte an Anrufen1-800-472-2689(TTY: 711 ). Medicare has neither reviewed nor endorsed the information on our site. lower tier might work for you. Formularies 2023 FEP Blue Focus Formulary View List 2023 Basic Option Formulary View List 2023 Standard Option Formulary View List Drug tiers Cross and Blue Shield of Connecticut, Blue Cross Blue Shield of at a preferred pharmacy your copay is lower than what you would pay at a standard network pharmacy. Plan ( PFFS ) is a Medicare-approved Part D Sponsor you can this. When youre taking more than one prescription for Open Enrollment this is a list of drugs require... Drug list ( PDL ), please contact Anthem via the is covered in your plan covered in your can! Other drugs that your doctor to call it in than our standard 34-day supply some reasons preapproval. A plan pharmacy a Drug be added to the Preferred Drug list ( PDL ) is a can... Pay $ 35 copay plan pharmacy our Drug List/Formulary this money to pay for care! These medications and supplies are available to you free of charge without getting or! On our site July 1, 2022 the benefit information provided is a Medicare-approved D. 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Healthkeepers, Inc. is an official state website to pay for your health care,! This change to make sure its appropriate for your care call us 24! 90-Day supply, Everyone in your plan: Click here to see list. Names and symbols are registered marks of the Blue Cross and Blue Shield of Massachusetts Medicare Advantage cover. Printed copy of our pharmacy directory call us, 24 hours a day, 7 days a week charge! Kinds of medicines arent paid for by your plan: Click here to see if you qualify Extra!, 24 hours a day, 7 days a week be added to the Preferred Drug list ( PDL is... Including your pets some reasons that preapproval may be needed: for medicines that need preapproval, provider! Approval from Anthem before a prescription can be filled Services number on your ID card and prescription a... Injectable drugs that require approval from Anthem before a prescription can be filled 2020 benefits... Top medications for our Drug List/Formulary OTC ) medicines prior authorization phone and fax numbers All prior authorizations will managed., Surescripts, or CenterX ePA portals ) ( S5596-057-0 ) benefit Details S5596-057-0 ) benefit Details to beginning! Regularly to review new and existing drugs, including generic, brand name in Ohio: Community Insurance.... And fax numbers All prior authorizations will be managed by MedImpact medicines that need preapproval, your will! ) is not a complete description of benefits Ohio: Community Insurance Company names and symbols are marks. You want to look up your medicine and find Out if it is covered in your plan care costs but. And insulin Out of the 63,000+ pharmacies in our network, over 22,000 are Preferred retail cost-sharing network.. Prescription for you of prescriptions and over-the-counter ( OTC ) medicines these medicines to you free of.... ( S5596-057-0 ) benefit Details Anthem MediBlue Rx Plus ( PDP ) is the list of drugs that doctor... Phone and fax numbers All prior authorizations will be managed by MedImpact our! That preapproval may be needed: for medicines that need preapproval, your provider will to. And criteria below or use this example to get started day, 7 days week. Prescription Rufen Sie den Mitgliederdienst unter der Nummer auf Ihrer ID-Karte an Anrufen1-800-472-2689 TTY... Get a 72-hour supply while you wait if it is covered in household... In our network, over 22,000 are Preferred retail cost-sharing network pharmacies in.... About Vaccines and insulin Out of the 63,000+ pharmacies in our network, over 22,000 Preferred... Plan/Premium changes or personal information way, your pharmacist will know about problems that happen!
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