See how we help keep your out-of-pocket costs low for the medications you and your family need. Our three plan options have certain drugs that are not covered on their formularies. after 1/1/22), 2021 Source+Rx 2.0 FEP offers a comprehensive suite of resources to help current and prospective members choose the best medical, dental and vision plan for them and their families, including the AskBlue medical, dental and vision plan finder tools, prescription drug cost tool and health cost advisor tool. Discount Drug Program Quick Reference Guide. Most PDF readers are a free download. Proven to be safe and effective. Quality Care Thats Right for YouWhether you need a routine check-up or a specialty procedure, you want the best care you can find. (Plan year on or after 1/1/21). Specialty: Used to treat complex health conditions. Review the 2022 changes. If you are a BCBSIL member, log in to your Blue Access forMembersSM account to check your drug list and learn more about your prescription drug benefits. Tier 3 (Non-preferred brand): $125copay, Tier 2 (Preferred generic specialty, and Preferred brand specialty): 40% of our allowance ($350 maximum), Tier 4 (Preferred specialty): $65copay for up to a 30-day supply;$185copay for a 31 to 90-day supply The drug lists below are used for BCBSIL health plans that are offered through your employer. This may help lower your out-of-pocket costs. Preventive Drug List, Additional Standard This database provides information based on Generic, Preferred and Other Brand Drug copay . Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists: In the United States, Puerto Rico and U.S. Virgin Islands. Self and Family biweekly premiums will be $54.16, Standard Option: Please select your designated plan from the dropdown below and then search your specific Drug List. Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). The Blue Cross and Blue Shield Federal Employee Program has been providing quality healthcare coverage since 1960. FEP Blue Focus has only two drug tiers. BCBS FEP Dental Standard Option will cover Class A (Basic), B (Intermediate), and C (Major) services for children at 100% when these services are provided by in-network providers. FEP Blue Focus: Look at our prescription drug coverage. Typically have a higher cost because these drugs have either a generic or Preferred brand available. For a complete list of QLEs . Members get access to over 55,000 Preferred pharmacies in the U.S. You can easily view and access your claims and statements. We organize our covered prescription drugs into tiers. 2022, BlueCross and BlueShield of Alabama is an independent licensee of the BlueCross and BlueShield Association. prescribed. Specialty drugs are limited to a 30-day supply. Review the 2022 changes. alternative medications that will lower your copayment and/or the amount you are required to pay out of pocket. FEP Blue Focus has only two drug tiers. Select Blue Cross Blue Shield Globalor GeoBlue if you have international coverage and need to find care outside the United States. Please call Customer Service at the number listed on your member ID card to confirm your correct drug list. Used to treat complex health conditions. Take a look at the changes and updates for 2023. Blue Cross and Blue Shield of Alabama does not prescribe medication nor do we attempt to alter what your doctor has prescribed. Visit the. This website is owned and operated by USAble Mutual Insurance Company, d/b/a Arkansas Blue Cross and Blue Shield. We offer this information on prescription drugs to ensure that our members receive quality, cost-effective medications. Be sure to review your benefit materials for details. 4 tiers (standard), SourceRx 2.0 Drug List Your member ID card is your key to using your medical plan benefits. Returning Shopper? Discounted prices are only available at participating retail pharmacies. Proven to be safe, effective, and favorably priced compared to Non-preferred brands. The Blue Cross Blue Shield Association (BCBSA) is the trade association for the independent, locally operated Blue Cross and Blue Shield member companies. See if your drug is covered under your selected plan and compare costs of covered drugs for all three plans. Note: The 2022 drug lists may not apply for all members. Tier 2 (Preferred generic specialty, and Preferred brand specialty): 40%of our allowance ($350 maximum). We organize our covered prescription drugs into tiers. Medications handled by the Specialty Pharmacy Program include oral, inhaled, injected and infused drugs, and they often require complex care, a high level of support and specific guidelines for shipment and storage. If you do not see your plan, please login to, Provider-Administered Drug Policies and Forms, Blue Choice Platinum for If you are a BCBSIL member, log in to your Blue Access forMembersSMaccount to check your drug list and learn more about your prescription drug benefits. It lists all the drugs your plan covers, plus any special rules you'll need to follow with certain medications. Dental Benefits. Once you choose to link to another website, you understand and agree that you have exited this Call the number listed on your member ID card if you have any questions. This is a summary of the features of the Blue Cross and Blue Shield Service Benefit Plan. View a preview of your drug list effective January 1, 2023: The drug lists below are used for BCBSTX health plans that are offered through your employer. ABCBS makes no warranties or representations of any kind, express or implied, nor Tier 2 (Preferred brand): $90copay BCBS FEP Dental has also released a suite of new features for its mobile app, which will allow members to view benefit, coverage and claim information, and access their ID card, all in one location. You can get up to a 90-day supply for one copay. Call the number on the back of your ID card if you have any questions. Our AskBlueSM FEP Medical Plan Finder tool can help you select the right plan. Typically the most affordable drug type, and are equal to their brand name counterparts in quality, performance characteristics and intended use. We use cookies on this website to give you the best experience and measure website usage. This drug list is updated monthly. See how you can get rewarded for taking charge of your health. Arkansas Blue Cross and Blue Shield offers help to members who lost their medication in Hurricane Ian, Information about COVID-19 and your insurance coverage, Statement regarding OneTouchPoint, Inc. (OTP) cyberattack. External link You are leaving this website/app (site). Self Only biweekly premiums will be $3.56 Understand your medications and possible side effects, Review your lab results to make sure your medications are safe and working for you, Work directly with your health care provider(s) if there are any medication-related concerns, Find ways to save money on your medications, Learn more about your health care benefits and resources, Evaluate your use of herbal products, supplements and over-the-counter treatments for safety and appropriateness. Search our nationwide directory to find Preferred providers near you. We are proud to have been part of the Federal Employees Health Benefits (FEHB) Program since its inception in 1960. third-party website link available as an option to you, ABCBS does not in any way endorse any such website, Please go to bcbsfepdental.com to see the full list of regional rates. Returning Shopper? Blue Cross and Blue Shield of Alabama does not prescribe medication nor do we attempt to alter what your doctor has Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. All benefits are subject to the definitions, limitations, and exclusions set forth in the federal brochure. The drug list below is used with your health plan if all of these apply to you: Your prescription drug benefits through BCBSIL are based on the Basic Drug List or the Basic Annual Drug List, which is a list of drugs considered to be safe and effective. If the coverage request is denied, BCBSIL will let you and your prescriber (or authorized representative) know why it was denied and offer you a covered alternative drug (if applicable). Prescription Drug List, 2023 Source+Rx 2.0 Prescription Drug List(Plan year on or To locate the address and telephone number for a local Blue Cross and Blue Shield company, please visit fepblue.org/contact-us. By continuing to use this website, you consent to these cookies. copay; $15 copay for a 31 to 90-day supply, Our three plan options have certain drugs that are not covered on their formularies, FEP Blue Focus members can apply for coverage of a drug not covered on their formulary with the, Non-Formulary Exception Process (NFE) form, Available to members with Medicare Part B primary only. Were honored to say that this has helped make us the number one health insurance choice for federal employees, and why 99% of our members choose to stay with us year after year. They are responsible for processing claims and providing customer service to our members. 5(g). Before making a final decision, please read the Plans Federal brochures (Standard Option and Basic Option: RI 71-005; FEP Blue Focus: 71-017). Drug List, NetResults ACA Preventive . 5(g). Basic Option and Standard Option each have five drug tiers. may be offered to you through such other websites or by the owner or operator of such other websites. All benefits are subject to the definitions, limitations, and exclusions set forth in the federal brochure. . These drugs are often given to you in a hospital, doctors office or health care setting. that are offered through your employer. cost-effective medications. BCBS FEP Vision plans will offer a second eye exam, frame and second pair of lenses when a prescription changes for children aged 13 and under. See how we can help you make the best decisions about your health care needs. affiliates, its directors, officers, employees and agents ("the ABCBS Parties") are not responsible for The pharmacy will ask you to pay the full amount for these items and then you will need to file a claimwith us for reimbursement. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. The 34 local member companies of the BCBSA are the primary points of contact for Service Benefit Plan members. These prescription drug lists have different levels of coverage, which are called "tiers". The Blue Cross Blue Shield Association is an association of independent, locally operated Blue Cross and Blue Shield companies. Heres what you need to know for Open Season, running Nov. 14Dec.12, 2022. See your plan materials for details. The drug lists below are used withBCBSTX"metallic" health plansthat are offered through your employer. PDF. If you are a BCBSTXmember, log in to yourBlue Access forMembersSMaccount to check your drug list and learn more about your prescription drug benefits. A drug list is a list of drugs available to Blue Cross and Blue Shield of Illinois (BCBSIL) members. Note for members: If your employer offers health plan coverage and your prescription drug benefits are administered by Prime Therapeutics, you'll find information about prescription drugs when you're signed in. 5(h). (If your prescription drug benefits are administered by another company, please contact your human resources team . (Plan year on or after 1/1/22), 2021 Source+Rx 1.0 Prescription Drug List If your benefit plan is not changing drug lists, these changes will not apply. Proven to be safe, effective, and favorably priced compared to Non-preferred specialty drugs. For refills, call: 1-877-FEP-FILL (1-877-337-3455), Get prescription advice from a registered nurse. the content of any other website to which you may link, nor are ABCBS or the ABCBS Parties liable or responsible Blueprint Portal is a members-only website that will help you understand and manage your health plan so youre able to find quality, patient-focused healthcare at the best possible price. Visit the Prior Authorization and Step Therapy section for more information. Non-HMO Drug List. Precertification Drug List, Standard ACA Preventive Today, FEP covers over 5.5 million federal employees, retirees and their families across the U.S. and overseas. What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. The formulary is a list of our covered prescription drugs, including generic, brand name and specialty drugs. All Standard Option members, as well as Basic Option members with Medicare Part B primary, can get prescription drugs they regularly take conveniently delivered to their home. If you do not see your plan, please login to myBlueCross to view your specific information. You further agree that ABCBS and its Self Only biweekly premiums will be $53.14 The amount you pay for a drug depends on the tier. Our Prescription Drug Cost Tool lets you check drug costs 24/7. BCBSIL contracts with Prime to provide pharmacy benefit management and related other services. Heres everything you need to know about it. Basic Option and Standard Option each have five drug tiers. Check out the changes and updates to our plan in 2023. If your company has 150 employees, your prescription drug benefits through BCBSIL may be based on the Basic Drug List, Basic Annual Drug List, Enhanced Drug List or the Enhanced Annual Drug List. If you have a health condition that may jeopardize your life, health or keep you from regaining function, or your current drug therapy uses a non-covered drug, you, your prescriber, or your authorized representative, may be able to ask for an expedited review process. Cheaper than Non-preferred brands but more expensive than generics. View your current drug list effective January 1, 2022: Starting January 1, 2022, some changes were made to the prescription drug benefit. We offer this information on prescription drugs to ensure that our members receive quality, after 1/1/23), 2022 Source+Rx 2.0 Plans. We organize our covered prescription drugs into tiers. If the coverage request is denied, BCBSTX will let you and your prescriber (or authorized representative) know why it was denied and offer you a covered alternative drug (if applicable). We use cookies on this website to give you the best experience and measure website usage. * Please note: IL HMO plans will be on the Performance Annual Drug List that is updated only once a year. View your drug list effective January 1, 2023: Starting January 1, 2023, some changes will be made to the prescription drug benefit. WASHINGTON, Sep. 30, 2021 - Today the Blue Cross and Blue Shield (BCBS) Government-wide Service Benefit Plan, also known as the Federal Employee Program (FEP), announced 2022 benefits available to eligible participants in the Federal Employees Health Benefits (FEHB) Program and the Federal Employees Dental and Vision Insurance Program (FEDVIP). Standard Option: These can includePlatinum, Gold, Silver, or Bronzeplans. Your member ID card is your key to using your medical plan benefits. Remember: Treatment decisions are always between you and your doctor. For 60 years, the Blue Cross and Blue Shield Service Benefit Plan, also known as the Federal Employee Programor simply FEPhas provided health insurance to the federal employee workforce. These new drugs will be subject to the same restrictions that generally apply to their particular drug class. URAC Accredited - Health Plan with Health Insurance Marketplace (HIM) - 7.3, URAC Accredited - Health Utilization Management - 7.4, Information regarding North Highland, LLC, ransomware attack, Member forms - Individual and family plans, Coverage policy and pre-certification/pre-authorization, Approval information for radiological services, Prior approval form for prescription drugs, 2022 Standard with Step Therapy Drug List, 2023 Standard with Step Therapy Drug List, 2023 Metallic 5 Tier Formulary (for Standardized plans only), View more Employer Coverage pharmacy information, 2023 Blue Choice Formulary (for Blue Choice Plans), 2023 Complete Formulary (for Complete/Complete Plus plans), View more Individual & Family pharmacy information, 2022 Medicare Prescription Drug Resources, 2023 Medicare Prescription Drug Resources, Check deductible and out-of-pocket totals. List, Specialty Copay Incentive $0 HDHP-HSA Preventive Drug List (This applies only for Blue Choice Preferred Bronze PPO SM 502 plan) Please note: Some drugs may be covered under your health plan's medical benefits instead of your pharmacy benefits. The drug lists below are used for BCBSTX health plans that are offered through your employer. . BCBSTX will let you, your prescriber (or authorized representative) know the coverage decision within 72 hours after they receive your request. The coverage gap is a temporary limit where you are responsible for all of . We want to make sure you and your family have convenient access to the prescription drugs you need. Starting January 1, 2022, some changes will be made to the prescription drug benefit for select large group members. See if your medicines are covered, get pricing and learn about ways to save. What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. These drug lists are a continually updated list of covered drugs. Heres everything you need to know about it. The protection of your privacy will be governed by the privacy policy of that site. All Rights Reserved. specific benefit plan details to see how drugs will be covered under your plan. Insights, information and powerful stories on how Blue Cross Blue Shield companies are leading the way to better healthcare and health for America. (844) 693-0163. To request this exception, you, your prescriber, or your authorizedrepresentative, can call the number listed on your BCBSTX member ID card to ask for a review. 2022 Blue Cross Blue Shield Association. I'm an Active U.S. Drugs that are not shown are not covered. Welcome to BCBS FEP 2022 Open Season Nov. 14 - Dec. 12, 2022. Our three plan options have certain drugs that are not covered on their formularies. In general, the lower the drug tier the more cost effective the drug. You can speak directly with a clinical pharmacist over the phone or via video chat to get help managing your medication therapy and lifestyle choices so you can reach your health goals. Cheaper than Non-preferred brands but more expensive than generics. View your current drug list effective January 1, 2022: Starting January 1, 2022, some changes were made to the prescription drug benefit. Drug List, Additional SourceRx HSA To learn more read Microsoft's help article. If your company has 150 employees, your prescription drug benefits through BCBSIL are based on a Drug List, which is a list of drugs considered to be safe and effective. This new site may be offered by a vendor or an independent third party. Each non-covered drug has safe and effective, alternative covered drug options. The drug lists below are used with your health plan if all of these apply to you: Your prescription drug benefits through BCBSIL are based on a Drug List, which is a list of drugs considered to be safe and cost-effective. View a preview of your drug list effective January 1, 2023: The drug lists below are used for BCBSIL health plans that are offered through your employer. For refills, call: 1-877-FEP-FILL (1-877-337-3455), Get prescription advice from a registered nurse. Blue Cross and Blue Shield of Illinois, aDivision of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). You can see the list of whats not covered and available alternative options for Standard Option and Basic Option. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. All benefits are subject to the definitions, limitations, and exclusions set forth in the federal brochure. Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. Check your benefit materials for details. Many drugs will remain covered on the new list. You can see the list of whats not covered and available alternative options for Standard Option and Basic Option. Drug List Change. Drugs covered under your medical benefit must be . We'd suggest starting in one of these areas: Error: Please enter a valid email address. Generics Only HSA Preventive Drug While discounts may vary, you can save an average of 24% off some prescription drugs and save the most on generic drugs. Your BCBS FEP coverage will automatically carry over to 2023 so you don't need to do anything. Step Therapy Clinical Documentation. View your drug list effective January 1, 2023: Starting January 1, 2023, some changes will be made to the prescription drug benefit. BCBSA corporate headquarters are located at 225 North Michigan Avenue, Chicago, Illinois 60601. Coordinating Benefits With Medicare and Other CoverageWhen you h Medicare prescription drug coverage (Part B) If you have Standard Option, you may still purchase your prescription drugs and supplies from Non-preferred retail pharmacies. Review the 2022 changes. This is a summary of the features of the Blue Cross and Blue Shield Service Benefit Plan. The protection of your privacy will be governed by the privacy policy of that site. others in any way for your decision to link to such other websites. For more information, view our privacy policy. Renew Illinois Individual, Family & Medicaid Health Insurance, Blue Cross Community MMAI (Medicare-Medicaid Plan), Making Your Health Insurance Work For You, Prescription Drug Changes and Pharmacy Information, Machine Readable Files for Transparency in Coverage, 2022 Basic Annual Drug List Updates Summary, 2022 Multi-Tier Basic Drug List Updates Summary, 2022 Multi-Tier Basic Annual Drug List Updates Summary, 2022 Enhanced Annual Drug List Updates Summary, 2022 Multi-Tier Enhanced Drug List Updates Summary, 2022 Multi-Tier Enhanced Annual Drug List, 2022 Multi-Tier Enhanced Annual Drug List Updates Summary, 2023 Multi-Tier Enhanced Annual Drug List, You enrolled in a plan on your own (instead of through your employer) and, Your plan is a "metallic" health plan, which can include a. To request this exception, you, your prescriber, or your authorized representative, can call the number on the back of your ID card to ask for a review. These drug lists are a list of drugs considered to be safe and effective. Answer a few questions and get a personalized health action plan. FEP Blue Focus premiums remain flat for fourth consecutive year, Blue Cross and Blue Shield Federal Employee Program (FEP) Introduces Enhanced Hypertension and Pregnancy Programs, Dental and Vision Benefits and New International Travel Insurance, New Study: No Surprises Act Protects 9 Million Americans from Surprise Medical Bills, Blue Cross Blue Shield Association Statement on the Election of the 118th Congress, Blue Cross and Blue Shield Federal Employee Program Expands Preventive Care, Maternity Care and Dental Benefits, New Blue Cross Blue Shield Association Report Finds Racial and Ethnic Disparities in Maternal Health Complications Climbed During COVID-19 Pandemic, Blue Cross Blue Shield Association Names David Merritt SVP of Policy and Advocacy, Blue Cross and Blue Shield of Louisiana Offers Services to Members Affected by Hurricane Ida, Blue Cross Of Idaho And The Blue Cross Of Idaho Foundation For Health Commit To Expanding Health Equity Across Idaho, Blue Cross Blue Shield of Wyoming Announces New Board Member, James G. Springfield Named President of Blue Cross and Blue Shield of Texas. Prescription Drug List (Plan year on or If this applies to you*, all covered prescription drugs are shown on the list. If this applies to you*, all covered prescription drugs are shown on the list. See the 2021 changes. By continuing to use this website, you consent to these cookies. For 60 years, the Blue Cross and Blue Shield Service Benefit Plan, also known as the Federal Employee Programor simply FEPhas provided health insurance to the federal employee workforce. If the coverage request is denied, BCBSTX will let you and your prescriber (or authorized representative) know why it was denied and offer you a covered alternative drug (if applicable). Drug list, Drug Exclusion Strategy Check out the changes and updates to our plan in 2023. BCBSIL will let you, your prescriber (or authorized representative) know the coverage decision within 72 hours after they receive your request. Be sure to verify that your specialty medication is covered with Vermont Blue Rx prior to having it filled. Select a state for information that's relevant to you. In general, the lower the drug tier the more cost effective the drug. The full list of drugs that need to be approved, prior approval forms and additional information can be downloaded here. Fill your prescription as you normally would by using the Retail or Mail Order Pharmacy Programs for non-specialty drugs or the Specialty Pharmacy Program for specialty drugs. FEP will waive early medication refill limits on 30-day prescription maintenance medications. In general, the lower the drug tier the more cost effective the drug. Type in the word or phrase you are looking for and click on Search. All of our health plans include comprehensive prescription drug coverage. Some Part D plans require that you pay a percentage (coinsurance) of a medication's cost every time you fill a prescription. Preventive Drug List, SourceRx Value Based List, SourceRx ACA Preventive Please tell us who you are. These drug lists are a list of drugs considered to be safe and effective. We have a network of over 55,000 Preferred retail pharmacies nationwide to fill your prescriptions. Heres everything you need to know about it. In addition, some sites may require you to agree to their terms of use and privacy policy. To give prior approval, we need to confirm two things: that youre using the drug to treat something we cover and that your health care provider prescribes it in a medically appropriate way. The drug lists below are used withBCBSIL "metallic" health plansthat are offered through your employer. Important: Blueprint Portal will not load if you are using Internet Explorer. *BCBS FEP Dental rates depend upon the rate region in which a member lives. Be the first to know about our benefits, wellness incentives and rewards you're eligible for with your plan. The amount you pay for a drug depends on the tier. or operation of any other website to which you may link from this website. 2022 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus FEHB Facts Coverage information: Types of coverage available for you and your family . Specialty Drug List, Provider-Administered Your health care provider can request prior approval by contacting your local BCBS company. Self and Family biweekly premiums will be $10.67, Blue Cross Blue Shield FEP Dental Premiums in 2022*, High Option: These can include drugs that must be given to you by a health care provider. Home - Blue Cross and Blue Shield's Federal Employee Program. The Blue Cross and Blue Shield Service Benefit Plan, also known as the Federal Employee Program (FEP), has been part of the Federal Employees Health Benefits (FEHB) Program since its inception in 1960. But, some drugs you use: Will move to a higher or lower drug tier and out-of-pocket cost (copay/coinsurance amount), Have new additional requirements (prior authorization, step therapy or dispensing limits) to meet first before coverage can be approved, If youd like to see if your medication is impacted, you can. Drug List Change. The Blue Cross Blue Shield Association negotiates annually with the U.S. Office of Personnel Management (OPM) to determine the benefits and premiums for the Blue Cross and Blue Shield Service Benefit Plan. To search for a drug name within the PDF Drug List document, use the Control and F keys on your keyboard, or go to Edit in the drop-down menu and select Find/Search. Review the 2023 changes. If you are taking or prescribed a drug that is not on your plan's Drug List, call the number on your member ID card to see if the drug may be covered by your medical plan. OPM requires FEHB plans be accredited to validate the Plan operations meet nationally recognized standards. The drug list below is used with your health plan if: Your prescription drug benefits through BCBSTX may be based on the Basic Drug List, Basic Annual Drug List, Enhanced Drug List or the Enhanced Annual Drug List. * You also have access to a registered pharmacist 24/7. Check out the changes and updates to our plan in 2023. What you need to know about the disease and our commitment to ensuring you have access to the right care at the right time. after 1/1/23), 2022 Source+Rx 1.0 Prescription Drug List Optum Rx. If you have a health condition that may jeopardize your life, health or keep you from regaining function, or your current drug therapy uses a non-covered drug, you, your prescriber, or your authorized representative, may be able to ask for an expedited review process. In addition, some sites may require you to agree to their terms of use and privacy policy. Please review the terms of use and privacy policies of the new site you will be visiting. Coverage is subject to the terms and limits of your benefit plan. Eligible participants will have an opportunity to make their coverage decisions during Open Season, which runs from Nov. 8 through Dec. 13, 2021. Please tell us a bit more about yourself: Interested in BCBS FEP: Federal Employee for More Than 1 Year. Dartmouth-Hitchcock Medical Center (DHMC) Pharmacy. under any circumstances for the activities, omissions or conduct of any owner or operator of any other Your health care provider can request prior approval electronically, by fax or by mail. To participate in the Mail Service Pharmacy Program, complete the Mail Service Drug Prescription Form, call CVS Caremark at 1-800-262-7890 or place an order through your MyBlue member account. Examples of these drugs are contraceptive implants and chemo infusion. Learn more about our Total Care and Blue Distinction Specialty Care designation programs and find a designated doctor or hospital that meets your needs. The drug lists below are used with your health plan if: Your prescription drug benefits through BCBSTX are based on a Drug List, which is a list of drugs considered to be safe and cost-effective. These drug lists are a continually updated list of covered drugs. Basic Option and Standard Option each have five drug tiers. Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. The site may also contain non-Medicare related information. Self Plus One biweekly premiums will be $36.11 Talk with your doctor, or pharmacist, about any questions or concerns you have about medicines you are prescribed. Preferred brand name: Proven to be safe, effective, and favorably priced compared to Non-preferred brands. after 1/1/22), 2021 Source+Rx 1.0 Basic Option: Starting January 1, 2021, some changes were made to the prescription drug benefit. You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. The site may also contain non-Medicare related information. Renew Illinois Individual, Family & Medicaid Health Insurance, Blue Cross Community MMAI (Medicare-Medicaid Plan), Making Your Health Insurance Work For You, Prescription Drug Changes and Pharmacy Information, Machine Readable Files for Transparency in Coverage, review the prescription drug list changes, download a list of commonly used drugs that will no longer be covered and their alternatives, review the full current Performance Drug List, review the full current Performance Annual Drug List. Some drugs must be given to you by a health care provider. We're encouraging our users to go ahead and switch to Microsoft Edge, Google Chrome, Safari or Firefox. To give prior approval, we need to confirm two things: that youre using the drug to treat something we cover and that your health care provider prescribes it in a medically appropriate way. 90-day supply may only be obtained after third fill. This is a summary of the features of the Blue Cross and Blue Shield Service Benefit Plan. Pharmacy and Prescription Plan Information. FEP has engaged a new fulfillment partner to support the Hypertension Management Program, Pregnancy Care Incentive Program and breast pump kit benefit. While discounts may vary, you can save an average of 24% off some prescription drugs and save the most on generic drugs. See how we help keep your out-of-pocket costs low for the medications you and your family need. These can include, Understanding Health Care Costs and Quality, Provider Finder -Network Selection Criteria, HMO Provider Network Important Information, Making Your Health Insurance Work For You, Prescription Drug Changes and Pharmacy Information, Machine Readable Files for Transparency in Coverage, 2022 Basic Annual Drug List Updates Summary, 2022 Enhanced Annual Drug List Updates Summary, 2022 Multi-Tier Basic Drug List Updates Summary, 2022 Multi-Tier Basic Annual Drug List Updates Summary, 2022 Multi-Tier Enhanced Drug List Updates Summary, 2022 Multi-Tier Enhanced Annual Drug List, 2022 Multi-Tier Enhanced Annual Drug List Updates Summary, 2023 Multi-Tier Enhanced Annual Drug List, 2023 In-Vitro Fertilization (IVF) Drug List, 2022 In-Vitro Fertilization (IVF) Drug List. Most PDF readers are a free download. Specialty: Used to treat complex health conditions. View and download the Generic Incentive Program Drug Listto see if theres an alternative generic drug that can appropriately treat your condition. If your company has 51 or more employees, your prescription drug benefits through BCBSIL may be based on one of the following drug lists. You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. These changes can consist of new drugs available or new additional strengths, dosages or forms. We are proud to have been part of the Federal Employees Health Benefits (FEHB) Program since its inception in 1960. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Check your benefit materials for details. Discounted prices are only available at participating retail pharmacies. Drug List, Additional NetResults HSA Use our pharmacy locator tool to find one near you. By continuing to use this website, you consent to these cookies. Search for Doctors, Hospitals and Dentists Blue Cross Blue Shield members can search for doctors, hospitals and dentists:. Check your benefit materials or call the customer service number on your Member ID card. Alternative Drug List, Additional Standard HSA Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. Federal employees, annuitants and their family members are eligible for coverage through the FEHB Program, while FEDVIP is available to federal employees and annuitants, certain retired uniformed service members and active duty family members. To view this file, you may need to install a PDF reader program. The Internet Explorer 11 browser application will be retired and go out of support on June 15, 2022. We have options that fit your needs and budget. BCBSIL will let you, your prescriber (or authorized representative) know the coverage decision within 72 hours after they receive your request. Members can get lower prices on prescription drugs not covered by our pharmacy benefits. Review the 2023 changes. A drug list is a list of drugs available to Blue Cross and Blue Shield of Texas (BCBSTX) members. Before making a final decision, please read the Plan's Federal brochures (Standard Option and Basic Option: RI 71-005; FEP Blue Focus: 71-017). As we continue to navigate an unprecedented health crisis, Blue Cross Blue Shield FEP health, dental and vision members know they can count on us to make sure affordable and comprehensive health care is accessible no matter where they are, said William A. Breskin, senior vice president of government programs for the Blue Cross Blue Shield Association (BCBSA). You understand and agree that by making any For more information, view our privacy policy. The protection of your privacy will be governed by the privacy policy of that site. The site may also contain non-Medicare related information. These drug lists coverage ended December 31, 2021, with the exception of a plan with an off-cycle 2022 renewal date. If you are a BCBSIL member, log in to yourBlue Access forMembersSMaccount to check your drug list and learn more about your prescription drug benefits. Our care team helps you: Learn more about Patient-Centered Care or call 1-866-465-2505to enroll today. Log In to the Shopping Cart, Need to Make a Payment? (802) 847-3784. Access Your Payment Options. A drug list is a list of drugs available to Blue Cross and Blue Shield of Texas (BCBSTX) members. Each non-covered drug has safe and effective, alternative covered drug options. after 1/1/23), 2022 Source+Rx 1.0 Your doctor should consult the Drug List when prescribing drugs for you. Self and Family biweekly premiums will be $125.67 The Specialty Pharmacy Program offers more than just medication. Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. Enter drug name, or partial drug name, and click Rx Search to determine if your medication is available in the formulary. Arkansas Blue Cross and Blue Shield is an Independent Licensee of the Blue Cross and Blue Shield Association and is licensed to offer health plans in all 75 counties of Arkansas. Its also because in everything we do, our members health and well-being always come first. The local Plans and vendors that support the Blue Cross and Blue Shield Service Benefit Plan hold accreditation from National Committee for Quality Assurance (NCQA) and/or URAC. If the coverage request is denied, BCBSIL will let you and your prescriber (or authorized representative) know why it was denied and offer you a covered alternative drug (if applicable). Drug List, Vaccine Network Drug List, NetResults 1.0 Drug List Type column: X=print and mail, D=direct electronic connection to payer from BCBSM EDI, E=electronic transmission through clearinghouse BCBSM is a non profit corporation and independent licensee of the Blue Cross and Blue Shield Association 3 Payer ID Claim Office # Type Name Address City St Zip 98999 0010 X AMICA 900 VICTORS WAY ANN ARBOR MI 48106.LoginAsk is here to help you access Palmetto . Before making a final decision, please read the Plan's Federal brochures (Standard Option and Basic Option: RI 71-005; FEP Blue Focus: 71-017). 90-day supply may only be obtained after third fill. Before making a final decision, please read the Plans Federal brochures (Standard Option and Basic Option: RI 71-005; FEP Blue Focus: 71-017). Drugs to aid smoking and tobacco cessation that require a prescription by Federal law Note: We provide benefits for over-the . If you have any questions about your prescription drug benefits, call the number on your member ID card. If you are a BCBSTX member, log in to yourBlue Access for MembersSMaccount to check your drug list and learn more about your prescription drug benefits. This drug list coverage ended December 31, 2021, with the exception of a plan with an off-cycle 2022 renewal date. If your company has 150 employees, your prescription drug benefits through BCBSTX may be based on the Basic Drug List, Basic Annual Drug List, Enhanced Drug List or the Enhanced Annual Drug List. This is a summary of the features of the Blue Cross and Blue Shield Service Benefit Plan. BCBSTX will let you, your prescriber (or authorized representative) knowthe coverage decision within 24 hours after they receive your request for an expedited review. Tier 1 (Generics): $5 copay; $15 copay for a 31 to 90-day supply, Tier 2 (Preferred brand): 40% of our allowance ($350 max) for up to a 30-day supply; $1,050 maximum for 31 to 90-day supply, Tier 1 (Generics): $7.50 copay for up to a 30-day supply; $22.50 copay for a 31 to 90-day supply, Tier 2 (Preferred brand): 30% of our allowance, Tier 3 (Non-preferred brand): 50% of our allowance, Tier 4 (Preferred specialty): 30% of our allowance, Tier 5 (Non-preferred specialty): 30% of our allowance, Tier 1 (Generics): $15copay 6 tiers, SourceRx Alternative Drug Proven to be safe, effective, and favorably priced compared to Non-preferred brands. Please review the terms of use and privacy policies of the new site you will be visiting. after 1/1/21), Specialty Coupon Program Information for . We have a unique formulary for each of our three plan options. By continuing to use this website, you consent to these cookies. Thats why we have a variety of programs that help you get your prescriptions at your local pharmacy or delivered right to your door. Heres what you need to know for Open Season, running Nov. 14Dec.12, 2022. Nothing for the first 4 prescription fills or refills when you switch from certain brand name drugs to specific generic drugs. For more information, view our privacy policy. Note: If you have pharmacy coverage through your employer with a provider other than Prime Therapeutics, check with your employer or Pharmacy Benefit Manager (PBM) to see how OTC COVID-19 FDA-authorized test . Self Only biweekly premiums will be $127.47 Heres everything you need to know about it. Heres what you need to know for Open Season, running Nov. 14Dec.12, 2022. Please review the terms of use and privacy policies of the new site you will be visiting. Tier 1 (Generics): $5 copay; $15 copay for a 31 to 90-day supply, Tier 2 (Preferred brand): 40% of our allowance ($350 max) for up to a 30-day supply; $1,050 maximum for 31 to 90-day supply, Tier 1 (Generics): $7.50 copay for up to a 30-day supply; $22.50 copay for a 31 to 90-day supply, Tier 2 (Preferred brand): 30% of our allowance, Tier 3 (Non-preferred brand): 50% of our allowance, Tier 4 (Preferred specialty): 30% of our allowance, Tier 5 (Non-preferred specialty): 30% of our allowance, Tier 1 (Generics): $15copay *If the cost of your prescription is less than your copay, you pay only the cost of your prescription. If you have prescription drug coverage through Blue Cross and Blue Shield of Illinois (BCBSIL), this information can help you and your doctor get the most from your prescription drug coverage. Typically have a higher cost because these drugs have either a generic or Preferred brand available. Prime Therapeutics LLC is a pharmacy benefit management company. External link You are leaving this website/app (site). 2023 Blue Choice Formulary (for Blue Choice Plans) [pdf] 2023 Metallic 5 Tier Formulary (for Standardized plans only) [pdf] 2023 Metallic 6 Tier Formulary [pdf] 2023 Complete Formulary (for Complete/Complete Plus plans) [pdf] View more Individual & Family pharmacy information. Currently, Blue Advantage, BlueRx, C Plus, and Short Term Limited Duration plans are not included in the federal requirement for coverage. Also, you can refer to the BCBSTX will let you, your prescriber (or authorized representative) know the coverage decision within 72 hours after they receive your request. BCBSA negotiates annually with the U.S. Office of Personnel Management (OPM) to determine the benefits and premiums for the Service Benefit Plan. See pages 112-113 for our coverage of medications to promote better health as recommended under the Affordable . 5(h). This list is for small group or individual health plans that began on or after Jan. 1, 2014 and meet the requirements of the Patient Protection and Affordable Care Act. 6 tiers, NetResults Alternative All from the palm of your hand. Before making a final decision, please read the Plans federal brochures (RI 71-005 and RI 71-017). Call the National Information Center at 1-800-411-BLUE (2583) weekdays from 8 a.m. to 8 p.m. Eastern time. Additional information about 2022 benefits is available online or by calling the National Information Center. MyPrime.com is an online resource offered by Prime Therapeutics. Today, these members plan benefits are based on the Basic or Enhanced Drug Lists. To request this exception, you, your prescriber, or your authorized representative, can call the number on the back of your ID card to ask for a review. We use cookies on this website to give you the best experience and measure website usage. The 35 local member companies of the Blue Cross Blue Shield Association are the primary points of contact for Service Benefit Plan members. If you have a health condition that may jeopardize your life, health or keep you from regaining function, or your current drug therapy uses a non-covered drug, you, your prescriber, or your authorized representative, may be able to ask for an expedited review process. Updated Dental and Vision Digital Sites Drug List, Generics Plus Starting January 1, 2022, or on your group's 2022 renewal date, some member's benefit plans will be based on a new drug list - Performance Drug List. Or sign in to Blueprint Portalto find specific pharmacy information for your plan. In addition, some sites may require you to agree to their terms of use and privacy policy. One option is Adobe Reader which has a built-in reader. If the coverage request is denied, BCBSTX will let you and your prescriber (or authorized representative) know why it was denied and offer you a covered alternative drug (if applicable). 4 tiers (standard), SourceRx 1.0 Drug List You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. If you have any questions about your prescription drug benefits, call the number listed on your member ID card. How much you pay out-of-pocket for prescription drugs is determined by whether your medication is on the list. Today, these member's plan benefits are based on the Enhanced Drug List.*. Some drugs are covered under your medical plan instead of your pharmacy benefits. Enhanced Dental and Vision Benefits for Children Review the 2022 changes. BCBSIL, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime. Design Drug List, SourceRx 1.0 Drug List BCBSIL will let you, your prescriber (or authorized representative) know the coverage decision within 24 hours after they receive your request for an expedited review. Prescription Drug Benefits. Covers a 22 to 90-day supply. Heres everything you need to know about it. Before making a final decision, please read the Plans federal brochures (RI 71-005 and RI 71-017). Typically have a higher cost because these drugs have a Preferred specialty available. you may be eligible to enroll in the FEHB Program, change your enrollment, or cancel coverage. The Blue Cross Blue Shield System is made up of 34 independent and locally operated companies. These drugs are often covered under the medical plan and not listed on the prescription drug list. for federal employees, retirees and their families. Specialty drugs are limited to a 30-day supply. Tier 2 (Preferred brand): $90copay Phone Number. 24/7 access to pharmacists and nurses specifically trained in conditions like yours. Discover all the ways members can earn wellness incentives and rewards for taking an active role in their health. Learn more here. Review the 2022 changes. Type in the word or phrase you are looking for and click on Search. All benefits are subject to the definitions, limitations, and exclusions set forth in the federal brochure. In general, the lower the drug tier the more cost effective the drug. copay; $15 copay for a 31 to 90-day supply, Our three plan options have certain drugs that are not covered on their formularies, FEP Blue Focus members can apply for coverage of a drug not covered on their formulary with the, Non-Formulary Exception Process (NFE) form, Available to members with Medicare Part B primary only. All refills must be obtained from the Specialty Drug Pharmacy Program. How much you pay out-of-pocket for prescription drugs is determined by whether your medication is on the list. *Not all members benefits will make a drug list change. Outside the United States. Heres what you need to know for Open Season, running Nov. 14Dec.12, 2022. List, Provider-Administered Precertification These drug lists are a list of drugs considered to be safe and effective. These health plans are not a "metallic" health plan and were effective before January 1, 2014. in to myBlueCross for more specific pricing information. If you are a BCBSTX member, log in to your Blue Access forMembersSM account to check your drug list and learn more about your prescription drug benefits. Coordinating Benefits With Medicare and Other CoverageWhen you h . Here's your 2022 drug list (for coverage that renews or starts on or after January 1, 2022): $0 HDHP-HSA Preventive Drug List (This applies only for Blue Advantage Plus BronzeSM 501 plan) Some drugs may be covered under your health plan's medical benefits instead of your pharmacy benefits. This is a summary of the features of the Blue Cross and Blue Shield Service Benefit Plan. William A. Breskin, Senior VP, Government Programs. Available to Service Benefit Plan members at no cost, we offer a comprehensive medication-therapy management program. Check out the changes and updates to our plan in 2023. We have options that fit your needs and budget. Self Plus One biweekly premiums will be $18.44 To learn more on how to fill your prescriptions using this program, view and download our Discount Drug Program Quick Reference Guide. It is designed to ensure you have access to safe, medically appropriate, and cost-effective drugs. 2023 Source+Rx 1.0 Prescription Drug List, Source+Rx 1.0 The protection of your privacy will be governed by the privacy policy of that site. No matter which health plan you choose, you'll have access to a wide range of prescription drugs, an extensive pharmacy network, and . Find a designated doctor or hospital that meets your needs and budget cookies on this website is owned and by... Cancel coverage get prescription advice from a registered nurse some drugs must given... Cheaper than Non-preferred brands but more expensive than generics options that fit your needs cost-effective.! Generic drug that can appropriately treat your condition can get rewarded for taking charge of health! Get a personalized health action plan 225 North Michigan Avenue, Chicago Illinois! Thats right for YouWhether you need your hand can includePlatinum, Gold, Silver, or Bronzeplans registered nurse care. 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About the disease and our commitment to ensuring you have access to pharmacists and nurses specifically trained conditions! Do not see your plan Non-preferred brands, get pricing and blue cross blue shield federal prescription coverage list 2022 about ways to.. Having it filled easily view and download the generic Incentive Program and breast pump Benefit...

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