This is a list of drugs we will cover in 2023, including preferred and non-preferred drugs. Our. 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. All the drugs we cover are carefully selected to provide the greatest value while meeting the needs of our members. Saves you time by speeding up the medicine refill process. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. Out of the 63,000+ pharmacies in our network, over 22,000 are preferred retail cost-sharing network pharmacies. Anthem is a registered trademark of Anthem Insurance Companies, Inc. Hepatitis C medications Effective January 1, 2017, all hepatitis C medications will be covered through the OptumRx fee-for-service (FFS) program. Coverage is available to residents of the service area or members of an employer during the calendar year will owe a portion of the account deposit back to the plan. Get the mobile app IngenioRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Anthem. PDP-Compare: How will each 2021 Part D Plan Change in 2022? Note: Not all prescriptions are available at mail order. 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. 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. 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. BAA !KOHWIINDZIN DOO&G&: Din4 kehj7 y1n7[tigo saad bee y1ti 47 t11j77ke bee n7k1adoowo[go 47 n1ahooti. Your doctor can prescribe most of these medicines to you without getting preapproval or an OK from us. If you have the PreventiveRx Drug List (Preferred), please refer to the PreventiveRx Plus Drug List (National) above. In Indiana: Anthem Insurance Companies, Inc. The joint enterprise is a Medicare-approved Part D Sponsor. or union group and separately issued by one of the following plans: Anthem Blue Simply take your written prescription to a plan pharmacy or ask your doctor to call it in. All prior authorizations will be managed by MedImpact. Off-label drug use, which means using a drug for treatments not specifically mentioned on the drugs label. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. When you fill your prescription at a preferred pharmacy your copay is lower . Bring your member ID card and prescription to a plan pharmacy. Please note, this update does not apply to the Select Drug List and does not affect Medicaid and Medicare plans. Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont Registered Marks of the Blue Cross and Blue Shield Association. Its easy when you use our search tool. Sep 1, 2022 Products & Programs / Pharmacy 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. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. If you use another pharmacy, you should tell the pharmacist about all medicines you are taking. 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. How to use the Anthem Blue Cross Cal MediConnect Formulary. MedicareRx (PDP) plans. Contact the Pharmacy Member Services number on your ID card if you need assistance. We partner with CarelonRx Specialty Pharmacy and AcariaHealth to meet all your specialty medication needs. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. are currently taking the brand name drug. If you are an individual plan member, use the Medication Lookup tools to learn whether our Medicare Advantage plans cover your Medicare Part D prescription medications. and SM Service Marks are the property of their respective owners. If you need more medicine than the standard 34-day supply to treat a condition, you can ask us for prior authorization. S2893_2209 Page Last Updated 10/15/2022. ID 1-800-472-2689TTY 711 ). Limitations, copayments, and restrictions may apply. Use of the Anthem websites constitutes your agreement with our Terms of Use. : -, . Our primary concern is clinical appropriateness, not drug cost. You can compare Anthem Medicare Advantage plans available where you live to find a plan that covers the prescription drugs you need. 1-800-472-2689 (TTY : 711) . See individual insulin cost-sharing below. 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. Use the formulary to search by drug name or disease category: For Medi-Cal drug coverage, please use the Medi-Cal Contract Drug List. A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. 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. If you misplace your medicine or it is stolen, contact your provider. ATTENTION: If you speak a language other than English, language assistance services are available to you free of charge. Change State. Drugs not approved by the U.S. Food and Drug Administration (FDA). Important Message About What You Pay for Insulin - You wont pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier its on even if you havent paid your deductible, if applicable. To request a printed copy of our pharmacy directory call us, 24 hours a day, 7 days a week. 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. Blue MedicareRx Value Plus (PDP) and Blue MedicareRx Premier (PDP) are two Coverage is available to residents of the service area or members of an employer Blue MedicareRx (PDP) Value Plus (PDF) and Prior authorization forms for pharmacy services can be found on the Formspage. This plan covers select insulin pay $35 copay. Anthem is a registered trademark. . There may be some physician administered medical injectable drugs that require approval from Anthem before a prescription can be filled. For all medically billed drug (Jcode) PA requests, please continue to send those directly to Anthem for review. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Important Information About Vaccines and Insulin IngenioRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Anthem. Search by: State & Plan Enrollment in Blue MedicareRx (PDP) depends on contract renewal. 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. 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. Drugs for treatment of sexual or erectile dysfunction (ED). Also, when Express Scripts develops formularies based on the following principles: 1. 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.) 2022 Part D Formulary (List of Covered Drugs) Register on our website to choose to receive plan communications by email or online. * 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. 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. Type at least three letters and well start finding suggestions for you. Your prescribing doctor has to approve this change to make sure its appropriate for your care. There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. 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. Typing the name (at least first three letters) of the drug in the search box. Local, state, and federal government websites often end in .gov. 3. Most prescriptions can be written with refills. Appelez le Service adhrents au numro indiqu sur votre carte dassur appel1-800-472-2689 (TTY : 711 ). lower cost sharing tier and with the same or fewer restrictions. ATENO: Se fala portugus, so-lhe disponibilizados gratuitamente servios de assistncia de idiomas. New! You can also learn more about some of our online tools, like pricing a drug, by clicking on the link to the video. New! 1-800-472-2689(TTY: 711) . You should always verify cost and coverage information with your Medicare plan provider. 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. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. Attention Members: You can now view plan benefit documents online. Do not sell or share my personal information. To ensure a smooth member transition and minimize costs, providers should review these changes and consider prescribing medications on formulary, if appropriate. 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. : . You can log in to your account and manage your prescriptions filled through home-delivery pharmacy. 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. Cross and Blue Shield of Connecticut, Blue Cross Blue Shield of 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. Independent licensees of the Blue Cross Association. Customer Support Anthem Blue Cross and Blue Shield Medicaid (Anthem) will administer pharmacy benefits for enrolled members. Anthem Blue Cross and Blue Shield Medicaid is the trade name of Anthem Kentucky Managed Care Plan, Inc., independent licensee of the Blue Cross and Blue Shield Association. An official website of the State of Georgia. These kinds of medicines arent paid for by your plan: Click here to see the list of medications available for 90-day supply. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. Rele nimewo Svis Manm nan ki sou kat Idantitifkasyon w lan (Svis pou Malantandan Rele 1-800-472-2689 TTY: 711 ). are the legal entities which have contracted as a joint enterprise with the Centers 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. Blue MedicareRx Value Plus (PDP) and Blue MedicareRx Premier (PDP) are two In Connecticut: Anthem Health Plans, Inc. Drugs requiring the assistance of a medical professional (office-based injectables) are not covered under the pharmacy benefit. A drug for treatments not specifically mentioned on the following principles: 1 language assistance are. 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anthem formulary 2022