An official website of the State of Georgia. and SM Service Marks are the property of their respective owners. If you use another pharmacy, you should tell the pharmacist about all medicines you are taking. 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. Change State. lower tier might work for you. Use your drug discount card to save on medications for the entire family ‐ including your pets. lower cost sharing tier and with the same or fewer restrictions. 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. However, the Medicare Part D plan data changes over time and we cannot guarantee the accuracy of this information. Make sure you have your medicines when you need them. There is additional information needed about your condition so we can match it to the FDA approval of the drug and/or studies of effectiveness. S2893_2209 Page Last Updated 10/01/2022. If you need your medicine right away, you may be able to get a 72-hour supply while you wait. Type at least three letters and we will start finding suggestions for you. Some of the links on this page can only be viewed using Adobe Acrobat Reader. Blue MedicareRx Value Plus (PDP) and Blue MedicareRx Premier (PDP) are two This plan covers select insulin pay $35 copay. The Blue Cross name and symbol are registered marks of the Blue Cross Association. Our Medication Synchronization program (Med Sync) makes getting all your medicines easier at no extra cost to you. as required by Medicare. MedImpact, in conjunction with the Commonwealth of Kentucky, manages a list of drugs providers can choose from called a Preferred Drug List (PDL). However, the drug list is not intended to be a substitute for a doctor's clinical knowledge and judgment. Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., Anthem Blue Cross is the trade name of Blue Cross of California. We work with CarelonRx to provide these pharmacy benefits. 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). 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. Please call 844-336-2676 or fax all retail pharmacy PA requests to 858-357-2612 beginning July 1, 2021. (function() { It's good to use the same pharmacy every time you fill a prescription. The changes apply for only new prescriptions; members with existing prescriptions for these medications will not be impacted. Blue Shield of Vermont. We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. March 2023 Anthem Blue Cross Provider News - California, Action required: 2023 Consumer Grievance and Appeals attestation Requirement, Group number change for Screen Actors Guild-American Federation of Television and Radio Artists Health Plan, February 2023 Anthem Blue Cross Provider News - California, January 2023 Anthem Blue Cross Provider News - California, September 2020 Anthem Blue Cross Provider News - California. To get Nevada Medicaid benefits through Anthem, you must have limited income and live in one of our service areas. We provide our Q1Medicare.com site for educational purposes and strive to present unbiased and accurate information. Medicare evaluates plans based on a 5-Star rating system. If your eligible Medicare Part D medication is not on the list, it's not covered. , 1-800-472-2689(: 711 ). Call Member Services at the number below for more information. These medications and supplies are available at network retail pharmacies. These requirements include: If you believe your use of a drug meets all special requirements, or that you should be exempt from a requirement, Simply take your written prescription to a plan pharmacy or ask your doctor to call it in. We may immediately remove a brand name drug on our Drug List if we Drugs that would be covered under Medicare Part A or Part B. Your doctor can get the process started by calling the Pharmacy Member Services number on Tawagan ang Mga Serbisyo sa Miyembro sa numerong nasa iyong ID Card tumawag1-800-472-2689(TTY: 711 ). All the drugs we cover are carefully selected to provide the greatest value while meeting the needs of our members. ATTENZIONE: se parlate italiano, sono disponibili per voi servizi gratuiti di assistenza linguistica. There is a generic or pharmacy alternative drug available. Customer Support . Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., 2021 copyright of Anthem Insurance Companies, Inc. As a leader in managed healthcare services for the public sector, Anthem Blue Cross and Blue Shield Medicaid helps low-income families, children and pregnant women get the healthcare they need. 2023 Formulary (List of Covered Drugs) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN This formulary was updated on 08/30/2022. Note: Not all prescriptions are available at mail order. during the calendar year will owe a portion of the account deposit back to the plan. Sometimes, we must remove a drug immediately for safety reasons or due to its discontinuation by the manufacturer. If you had to pay for a medicine that is covered under your plan, you may submit a request for reimbursement form. View a summary of changes here . Compare plans What is a Medicare plan drug formulary? . HealthKeepers, Inc. is an independent licensee of the Blue Cross and Blue Shield Association. We look forward to working with you to provide quality services to our members. 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. Please note, this update does not apply to the Select Drug List and does not impact Medicaid and Medicare plans. Certain drugs on Blue MedicareRx formularies have special coverage requirements to ensure theyre used in a safe way and to help MedicareRx (PDP) plans. This tool will help you learn about any limitations or restrictions for any rug. 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. Registered Marks of the Blue Cross and Blue Shield Association. To find a pharmacy near you, use our pharmacy locator tool. If you have the PreventiveRx Drug List (Preferred), please refer to the PreventiveRx Plus Drug List (National) above. Your doctor can prescribe most of these medicines to you without getting preapproval or an OK from us. lancets, test strips). This ensures that our members use these drugs in a safe way. Page Last Updated: 05/13/2022 The Anthem HealthKeepers Plus plan also covers many over-the-counter (OTC) medicines with a prescription from your doctor. 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. You can call a licensed agent directly at 1-866-831-1126 . Enrollment in Blue MedicareRx (PDP) depends on contract renewal. 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. 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. 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. TTY users should call 711. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). 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. for Medicare & Medicaid Services (CMS) and are the risk-bearing entities for Blue Visit thePrior Authorization and Step Therapysection for more information. Also, displayed are some medications and supplies covered under your Part B of Original Medicare medical benefit. var gcse = document.createElement('script'); Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont are the legal entities that have contracted as a joint enterprise with the Centers for Medicare & Medicaid Services (CMS) and are the risk-bearing entities for Blue MedicareRx (PDP) plans. Our primary concern is clinical appropriateness, not drug cost. Cross and Blue Shield of Connecticut, Blue Cross Blue Shield of Massachusetts, Blue Cross & Blue Shield of Rhode Island, and Blue Cross and 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. Medically necessary office-based injectables are covered under the major medical benefit. For a complete listing please contact 1-800-MEDICARE (TTY users should call 1-877-486-2048), Featured In: Please note: The above plan information comes from CMS. This way, your pharmacist will know about problems that may happen when youre taking more than one prescription. You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Blue Shield of Vermont. BAA !KOHWIINDZIN DOO&G&: Din4 kehj7 y1n7[tigo saad bee y1ti 47 t11j77ke bee n7k1adoowo[go 47 n1ahooti. They will work with the pharmacy and the Anthem HealthKeepers Plus plan to review your case and replace your medicines as needed. tier or add new restrictions. or add a special coverage requirement. If you have the Essential formulary/drug list, this PreventiveRx drug list may apply to you: If you have the National formulary/drug list, one of these PreventiveRx drug lists may apply to you: If you have the National Direct formulary/drug list, one of these PreventiveRx drug lists may apply to you: Anthem has aligned the National and Preferred Drug Lists. 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. 2023 Medicare HMO Blue Formulary. S2893_2244 If you like the convenience of having your prescription drugs delivered, you may utilize the CVS Caremark Mail-order pharmacy. the plan cover a drug that is not included in the formulary. Drugs on the formulary are organized by tiers. Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield Medicaid. Anthem Medicare Preferred (PPO) with Senior Rx Plus with a $0 copay for Select Generics Please read: This document contains information about the drugs we cover in this plan. Anthem Blue Cross is the trade name of Blue Cross of California and Anthem Blue Cross Partnership Plan is the trade name of Blue Cross of California Partnership Plan, Inc. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. 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. Featured In: September 2020 Anthem Blue . 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. 3. for Medicare & Medicaid Services (CMS) and are the risk-bearing entities for Blue We offer an outcomes-based formulary. Prescription vitamins and minerals (except for prenatal vitamins and fluoride preparations). s.parentNode.insertBefore(gcse, s); For more information on your Medicare coverage, please be sure to seek legal, medical, pharmaceutical, or financial advice from a licensed professional or telephone Medicare at 1-800-633-4227. The P&T Committee also helps improve customer health through programs like drug utilization review, promoting medication safety and encouraging compliance. We make receiving prescriptions as convenient as possible. Bring your member ID card and prescription to a plan pharmacy. Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont Benefits, formulary, pharmacy network, premium and/or copayments/co-insurance may change on January 1 of each year. All drugs on the formulary are covered, but many require preapproval before the prescription can be filled. Coverage is available to residents of the service area or members of an employer Products & Programs / Pharmacy. PDP-Compare: How will each 2021 Part D Plan Change in 2022? Since 2014, Anthem Blue Cross and Blue Shield of Georgia (Anthem) has provided medical claims administration and medical management services for the State Health Benefit Plan (SHBP). Small Group 2023 Select Drug List (Searchable) | (PDF) Small Group 2022 Select Drug List (Searchable) | (PDF) Espaol. Call to speak with a licensed insurance agent and find plans in your area. 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). All the drugs we cover are carefully selected to provide the greatest value while meeting the needs of our members. TTY users should call, 1-800-325-0778; or your state Medicaid Office. Be sure to show the pharmacy your Anthem member ID card. Appelez le Service adhrents au numro indiqu sur votre carte dassur appel1-800-472-2689 (TTY : 711 ). An official website of the State of Georgia. Compare Anthem Part D Plans MediBlue Rx* Standard Part D Plan This plan is a good choice if you take fewer medications. (ID Card) 1-800-472-2689(TTY: 711 ). Drugs on the formulary are organized by tiers. you and/or your doctor must request a coverage determination before the plan will cover your drug. 2022 Medicare Part D Plan Formulary Information. One of these lists may apply to you if your plan includes the PreventiveRx benefit (members can receive certain preventive drugs at low or no cost). Dietary supplements, except for treatment of phenylketonuria (PKU). Anthem Blue Cross and Blue Shield Medicaid (Anthem) will administer pharmacy benefits for enrolled members. Llame al nmero de Servicio al Cliente que figura en su tarjeta de identificacin llamada 1-800-472-2689 (TTY: 711 ). Coverage is available to residents of the service area or members of an employer Well make sure you can get the quantity of medicines you need. Enrollment in Blue Cross Blue Shield of Massachusetts depends on contract renewal. With your secure online account, you can: You can have many prescription drugs shipped directly to your home through CarelonRx Home Delivery pharmacy. Call 1-800-472-2689 (TTY: 711). The drug is prescribed at a higher dosage than recommended. Clicking on the therapeutic class of the drug. Saves you time by speeding up the medicine refill process. Change State. 598-0820-PN-NE. Those who disenroll You can also learn more about some of our online tools, like pricing a drug, by clicking on the link to the video. covered by Anthem. Typing the name (at least first three letters) of the drug in the search box. See individual insulin cost-sharing below. 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. Drugs for cosmetic purposes or hair growth. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. o If a drug you're taking isn't covered, your doctor can ask us to review the coverage. . For more recent information or other questions, please contact Customer Care at 1-844-345-4577, 24 hours a day, 7 days a week. Please see PDPFinder.com or MAFinder.com for current plans. 500 MG VIAL [Zithromax], Everyone in your household can use the same card, including your pets. Since 2014, Anthem Blue Cross and Blue Shield of Georgia (Anthem)has provided medical claims administration and medical management services for the State Health Benefit Plan (SHBP). var cx = 'partner-pub-9185979746634162:fhatcw-ivsf'; Medicare Prescription Drug Plans available to service residents of Connecticut, Note: For Synagis or other medical injectable drug prior authorizations, please call 1-866-323-4126. 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. They choose drugs for these lists based on a number of factors including how well they work, value to patients and safety. TTY 711 ZIP & Plan If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan. PlanID Updates include changes to drug tiers and the removal of medications from the formulary. Tier assignments vary by plan. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). In Maine: Anthem Health Plans of Maine, Inc. For all medically billed drug (Jcode) PA requests, please continue to send those directly to Anthem for review. Use the formulary to search by drug name or disease category: For Medi-Cal drug coverage, please use the Medi-Cal Contract Drug List. Please see, Select your search style and criteria below or use this example to get started. Contact the plan provider for additional 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. A doctor can also call in the prescription for you. Providers who do not contract with the plan are not required to see you except in an emergency. Attention Members: You can now view plan benefit documents online. 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). Customer Support Local, state, and federal government websites often end in .gov. Attention Members: You can now view plan benefit documents online. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. 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. Checks your prescriptions for dosage, drug interactions, and duplication at the time of prescribing. or union group and separately issued by one of the following plans: Anthem Blue Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. 1-800-472-2689(TTY: 711) . The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. March 2023 Anthem Provider News - Indiana, February 2023 Anthem Provider News - Indiana, New ID cards for Anthem Blue Cross and Blue Shield members - Indiana, Telephonic-only care allowance extended through April 11, 2023 - Indiana, January 2023 Anthem Provider News - Indiana, September 2022 Anthem Provider News - Indiana. There are certain types of drugs that Blue MedicareRx cannot include in the formulary due to federal law, including: In addition, a Medicare Part D plan cannot cover: Blue MedicareRx (PDP) is a Prescription Drug Plan with a Medicare contract. 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. Blue MedicareRx formularies may change during a calendar year if we remove a drug, change a drugs tier, Blue MedicareRx (PDP) Value Plus (PDF) and Here are some reasons that preapproval may be needed: For medicines that need preapproval, your provider will need to call Provider Services. The request should include why a specific drug is needed and how much is needed. You pay nothing for these drugs and supplies covered under your Original Medicare medical benefit. Please call 844-336-2676 or fax all retail pharmacy PA requests to 858-357-2612 beginning July 1, 2021. Its good to use the same pharmacy each time you fill a prescription. Note: Not all prescriptions are available at mail order. We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Get started with Med Sync today. Check with your employer or contact the Pharmacy Member Services number on your ID card if you need assistance. Some medicines need a preapproval or an OK from the Anthem HealthKeepers Plus plan before your provider can prescribe them. To submit electronic prior authorization (ePA) requests online, use If you misplace your medicine or it is stolen, contact your provider. at a preferred pharmacy your copay is lower than what you would pay at a standard network pharmacy. Updates include changes to drug tiers and the removal of medications from the formulary. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Massachusetts, Rhode Island, and Vermont. The PDL includes all medications covered by Medicaid, including some over-the-counter drugs. (change state) If a change affects a drug you take, we will notify you at least 60 days in advance, Enrollment in Blue MedicareRx (PDP) depends on contract renewal. To submit electronic prior authorization (ePA) requests online, use Availity. In Kentucky: Anthem Health Plans of Kentucky, Inc. 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anthem formulary 2022
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