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. 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. You may also submit your request online through Cover My Meds, Surescripts, or CenterX ePA portals. MedicareRx (PDP) plans. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. The Anthem HealthKeepers Plus plan will review the request and give a decision within 24 hours. The changes apply for only new prescriptions; members with existing prescriptions for these medications will not be impacted. Last Updated: 03/01/2023. You can also learn more about some of our online tools, like pricing a drug, by clicking on the link to the video. ACHTUNG: Wenn Sie Deutsche sprechen, steht Ihnen kostenlos fremdsprachliche Unterstutzung zur Verfugung. 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. Saves you time by speeding up the medicine refill process. View a summary of changes here . Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. For more information contact the plan. are currently taking the brand name drug. 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. This plan is closed to new membership. Its easy when you use our search tool. Compare plans What is a Medicare plan drug formulary? (change state) 2. Medicare evaluates plans based on a 5-Star rating system. Note: For Synagis or other medical injectable drug prior authorizations, please call 1-866-323-4126. Learn more about Medicare formularies and find an Anthem Medicare Advantage Plan available near you that offers prescription drug coverage. ATTENTION: If you speak a language other than English, language assistance services are available to you free of charge. To ensure a smooth member transition and minimize costs, providers should review these changes and consider prescribing medications on formulary, if appropriate. You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Massachusetts, Rhode Island, and Vermont. : , , : .. Check with your employer or contact the Pharmacy Member Services number on your ID card if you need assistance. If prior authorization is required, providers must get approval from MedImpact before a prescription can be filled. View the upcoming formulary changes for 1-800-472-2689(TTY: 711). Call Member Services at the number below for more information. Contact Anthem Blue Cross and Blue Shield. Have more questions about Med Sync? You can compare Anthem Medicare Advantage plans available where you live to find a plan that covers the prescription drugs you need. Page Last Updated: 05/13/2022 Hours: Monday to Friday from 8 a.m. to 7 p.m. Eastern time. Star Ratings are calculated each year and may change from one year to the next. There may be some physician administered medical injectable drugs that require approval from Anthem before a prescription can be filled. Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition. Attention Members: You can now view plan benefit documents online. Blue MedicareRx (PDP) is accepted coast-to-coast at national pharmacy chains and grocery retailers, plus thousands of community-based independent pharmacies. When you fill your prescription at a preferred pharmacy your copay is lower . English Spanish Don't see it listed? Medical Policies and Clinical UM Guidelines, HEDIS (The Healthcare Effectiveness Data & Information Set), Early and Periodic Screening, Diagnostic and Treatment (EPSDT), Anthem Blue Cross Cal MediConnect Plan (Medicare-Medicaid Plan) 2019 List of Covered Drugs (Formulary), Medi-Cal Managed Care and Major Risk Medical Insurance Program Provider Manual, Anthem Blue Cross Cal MediConnect Plan (Medicare-Medicaid Plan) Provider Manual, MMP: Medical Injectables Prior Authorization Form, Drug List Addition/Clinical Criteria Change Request Form. Out of the 63,000+ pharmacies in our network, over 22,000 are preferred retail cost-sharing network pharmacies. The plan deposits You should always verify cost and coverage information with your Medicare plan provider. Blue Cross and Blue Shield of Massachusetts is an HMO and PPO Plan with a Medicare contract. 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. The formulary is a list of all brand-name and generic drugs available in your plan. 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. ATENO: Se fala portugus, so-lhe disponibilizados gratuitamente servios de assistncia de idiomas. Getting your prescriptions filled is easy. Bring your member ID card and prescription to a plan pharmacy. 634-0920-PN-CONV. Blue Shield of Vermont. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE Managed Care, Inc. (RIT), Healthy Alliance Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. See individual insulin cost-sharing below. Contact the plan provider for additional information. Appelez le Service adhrents au numro indiqu sur votre carte dassur appel1-800-472-2689 (TTY : 711 ). You can search or print your drug list from the options below. Before sharing sensitive or personal information, make sure youre on an official state website. 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). 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 formulary, also known as a drug list, for each Blue MedicareRx plan includes most eligible generic and brand-name drugs. 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. Effective with dates of service on and after October 1, 2020, and in accordance with the IngenioRx Pharmacy and Therapeutics (P&T) process, Anthem Blue Cross (Anthem) will update its drug lists that support commercial health plans. Visit theAppeals & Grievancessection for more information. There is no pharmacy copay for Cardinal Care and FAMIS members.. These requirements include: If you believe your use of a drug meets all special requirements, or that you should be exempt from a requirement, Medicare has neither reviewed nor endorsed the information on our site. Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. Use of the Anthem websites constitutes your agreement with our Terms of Use. The request should include why a specific drug is needed and how much is needed. Blue MedicareRx (PDP) is a Prescription Drug Plan with a Medicare contract. Call 1-800-472-2689 (TTY: 711). Also, displayed are some medications and supplies covered under your Part B of Original Medicare medical benefit. Local, state, and federal government websites often end in .gov. Updates include changes to drug tiers and the removal of medications from the formulary. Featured In: September 2020 Anthem Blue . : , . ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Those who disenroll lower tier might work for you. We offer an outcomes-based formulary. That means we use a balanced approach to drug list/formulary management, based on a combination of research, clinical guidelines and member experience. The benefit information provided is a brief summary, not a complete description of benefits. Independent licensees of the Blue Cross and Blue Shield Association. To ensure a smooth member transition and minimize costs, providers should review these changes and consider prescribing medications on formulary, if appropriate. 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. o If a drug you're taking isn't covered, your doctor can ask us to review the coverage. Enrollment in Blue MedicareRx (PDP) depends on contract renewal. 500 MG VIAL [Zithromax], Everyone in your household can use the same card, including your pets. CCC Plus: 1-855-323-4687 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. We have two drug lists that show which drugs are in your plan. 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. MedicareRx (PDP) plans. 2022 Medicare Part D Plan Formulary Information. * 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. Products & Programs / Pharmacy. New! Drugs that would be covered under Medicare Part A or Part B. Contact the Medicare plan for more information. Massachusetts, Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Medallion Medicaid/FAMIS: 1-800-901-0020 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. gcse.async = true; Customer Support Members may enroll in a Medicare Advantage plan only during specific times of the year. ET, seven days a week. Chiamate il Servizio per i membri al numero riportato sulla vostra scheda identificativachiamata1-800-472-2689(TTY: 711 ). as required by Medicare. Compare Anthem Part D Plans MediBlue Rx* Standard Part D Plan This plan is a good choice if you take fewer medications. TTY 711 Enrollment in Blue MedicareRx (PDP) depends on contract renewal. Benefits, formulary, pharmacy network, premium and/or copayments/co-insurance may change on January 1 of each year. We are an independent education, research, and technology company. 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. View a summary of changes here . This group meets regularly to review new and existing drugs, and to choose the top medications for our Drug List/Formulary. Make sure you have your medicines when you need them. Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield Medicaid. Search by: State & Plan (function() { Most prescriptions can be written with refills. If a sudden removal occurs, we will notify our affected members as soon as possible. There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. . Your doctor can prescribe most of these medicines to you without getting preapproval or an OK from us. 1-800-472-2689 (TTY : 711) . var gcse = document.createElement('script'); Our primary concern is clinical appropriateness, not drug cost. Change State. 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. The Blue Cross name and symbol are registered marks of the Blue Cross Association. : , . 2022 Part D Formulary (List of Covered Drugs) Register on our website to choose to receive plan communications by email or online. Prior authorization phone and fax numbers All prior authorizations will be managed by MedImpact. 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. Effective January 1, 2022, the Department of Health Care Services (DHCS) will transition all administrative services related to Medi-Cal Managed Care (Medi-Cal) pharmacy benefits billed on pharmacy claims from the existing fee-for-service fiscal intermediary (FI) under Medi-Cal or the members managed care plan to DHCS new pharmacy vendor/FI for Medi-Cal, Magellan Medicaid Administration, Inc. (Magellan). 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. Blue Cross Blue Shield of Massachusetts Medicare Advantage Plans cover both brand name drugs and generic drugs. are Independent Licensees of the Blue Cross and Blue Shield Association, Please call 844-336-2676 or fax all retail pharmacy PA requests to 858-357-2612 beginning July 1, 2021. Please note, this update does not apply to the Select Drug List and does not impact Medicaid and Medicare plans. Telefone para os Servios aos Membros, atravs do nmero no seu carto ID chamar 1-800-472-2689 (TTY: 711 ). Browse Any 2022 Medicare Plan Formulary (Drug List) 2022 Medicare Part D and Medicare Advantage Plan Formulary Browser This is archive material for research purposes. In Maine: Anthem Health Plans of Maine, Inc. All other drugs are limited to a 34-day supply. Some of the links on this page can only be viewed using Adobe Acrobat Reader. We make receiving prescriptions as convenient as possible. Products & Programs / Pharmacy. 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. On our website to choose the top medications for our drug list/formulary Part B to enroll in Medicare... 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