Massachusetts, Rhode Island, and Vermont. 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. gcse.type = 'text/javascript'; and SM Service Marks are the property of their respective owners. They choose drugs for these lists based on a number of factors including how well they work, value to patients and safety. Appelez le Service adhrents au numro indiqu sur votre carte dassur appel1-800-472-2689 (TTY : 711 ). To find a pharmacy near you, use our pharmacy locator tool. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. An independent group of practicing doctors, pharmacists and other health-care professionals meet often to look at new and existing drugs. Change State. 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. Important Information About Vaccines and Insulin Enrollment in Blue MedicareRx (PDP) depends on contract renewal. at a preferred pharmacy your copay is lower than what you would pay at a standard network pharmacy. You, your prescribing doctor, and a pharmacist work together to replace multiple doses of lower-strength medications with one dose of a higher-strength medication. The P&T Committee also helps improve customer health through programs like drug utilization review, promoting medication safety and encouraging compliance. MedImpact is the pharmacy benefits manager. 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. An official website of the State of Georgia. 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. 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. Drugs to relieve a cough or cold symptoms. The changes apply for only new prescriptions; members with existing prescriptions for these medications will not be impacted. Checks your prescriptions for dosage, drug interactions, and duplication at the time of prescribing. Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont Our. This process is called preapproval or prior authorization. Through Anthem, SHBP offers eligible members, including pre-65 Retirees a choice of three Health Reimbursement Arrangement (HRA) Plan Options: Gold HRA, Silver HRA . 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. For more information contact the plan. 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. '//cse.google.com/cse.js?cx=' + cx; Members may enroll in a Medicare Advantage plan only during specific times of the year. IngenioRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Anthem. MedicareRx (PDP) plans. Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). Drugs for treatment of anorexia, weight loss or weight gain. The Preferred Drug List (PDL) is the list of drugs that your doctor will use first when prescribing you medicine. We partner with CarelonRx Specialty Pharmacy and AcariaHealth to meet all your specialty medication needs. control costs. })(); This is archive material for research purposes. 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). The drug is prescribed at a higher dosage than recommended. Medicare Prescription Drug Plans available to service residents of Connecticut, There is no pharmacy copay for Cardinal Care and FAMIS members.. 'https:' : 'http:') + pharmacies in our network, over 22,000 To ensure a smooth member transition and minimize costs, providers should review these changes and consider prescribing a drug on formulary or on a lower tier, if appropriate. Express Scripts develops formularies based on the following principles: 1. Getting your prescriptions filled is easy. This way, your pharmacist will know about problems that may happen when youre taking more than one prescription. This tool will help you learn about any limitations or restrictions for any rug. Please see PDPFinder.com or MAFinder.com for current plans. are Independent Licensees of the Blue Cross and Blue Shield Association, New! 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. Your doctor can get the process started by calling the Pharmacy Member Services number on Anthem Blue Cross and Blue Shield Medicaid (Anthem) will administer pharmacy benefits for enrolled 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, 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. S2893_2209 Page Last Updated 10/01/2022. Customer Support Some medicines need a preapproval or an OK from the Anthem HealthKeepers Plus plan before your provider can prescribe them. Sep 1, 2022 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. 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. Small Group 2023 Select Drug List (Searchable) | (PDF) Small Group 2022 Select Drug List (Searchable) | (PDF) Espaol. This group meets regularly to review new and existing drugs, and to choose the top medications for our Drug List/Formulary. 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. : -, . are the legal entities which have contracted as a joint enterprise with the Centers Compare Anthem Part D Plans MediBlue Rx* Standard Part D Plan This plan is a good choice if you take fewer medications. Use the Drug Pricing Tool to price the medications you are currently taking and see which Blue MedicareRx plan is best for you. Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). Out of the 63,000+ pharmacies in our network, over 22,000 are preferred retail cost-sharing network pharmacies. Here are some reasons that preapproval may be needed: For medicines that need preapproval, your provider will need to call Provider Services. OTC drugs aren't shown on the list. Type at least three letters and well start finding suggestions for you. PlanID Member Service 1-800-472-2689(TTY: 711). Generally, a drug on a lower tier will cost less than a drug on a higher tier. 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. Blue MedicareRx (PDP) Value Plus (PDF) and Hepatitis C medications Effective January 1, 2017, all hepatitis C medications will be covered through the OptumRx fee-for-service (FFS) program. area. Limitations, copayments, and restrictions may apply. Attention Prescribing Providers with members who are enrolled in an Anthem California plan: The Prescription Drug Prior Authorization Or Step Therapy Exception Request Form must be used for all members enrolled in a California plan, regardless of residence. Anthem is a registered trademark. It features low $1 copays for tier 1 prescription drugs. However, the Medicare Part D plan data changes over time and we cannot guarantee the accuracy of this information. The request should include why a specific drug is needed and how much is needed. Click on your plan to find a network pharmacy near your home or wherever you travel. , 1-800-472-2689(: 711 ). 2022 Formulary for Open Enrollment This is a list of drugs we will cover in 2023, including preferred and non-preferred drugs. When you fill your prescription at a preferred pharmacy your copay is lower . 3. To ensure a smooth member transition and minimize costs, providers should review these changes and consider prescribing medications on formulary, if appropriate. ACHTUNG: Wenn Sie Deutsche sprechen, steht Ihnen kostenlos fremdsprachliche Unterstutzung zur Verfugung. Phone: 800-977-2273 or 711 for TTY. Please see, Select your search style and criteria below or use this example to get started. If you like the convenience of having your prescription drugs delivered, you may utilize the CVS Caremark Mail-order pharmacy. 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. Simply take your written prescription to a plan pharmacy or ask your doctor to call it in. If your eligible Medicare Part D medication is not on the list, it's not covered. Dose optimization, or dose consolidation, helps you stick with your medicine routine. Browse Any 2022 Medicare Plan Formulary (Drug List), 2022 Medicare Part D and Medicare Advantage Plan Formulary Browser, Find a 2023 Medicare Advantage Plan (Health and Health w/Rx Plans), Browse Any 2023 Medicare Plan Formulary (or Drug List), Q1Rx Drug-Finder: Compare Drug Cost Across all 2023 Medicare Plans, Find Medicare plans covering your prescriptions, Medicare plan quality and CMS Star Ratings, Understanding Your Explanation of Benefits, IRMAA: Higher premiums for higher incomes, 2023 Medicare Advantage Plans State Overview, 2023 Medicare Advantage Plan Benefit Details, Find a 2023 Medicare Advantage Plan by Drug Costs. The Blue Cross name and symbol are registered marks of the Blue Cross Association. Overall, your costs for a 90-day supply of prescriptions ordered through our mail order service will be lower than what you will pay for a 90-day supply at a network retail pharmacy. 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. The Anthem MediBlue Rx Plus (PDP) (S5596-057-0) Formulary Drugs Starting with the Letter A. in CMS PDP Region 16 which includes: WI. 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. Non-prescription drugs (also called over-the-counter drugs). If you had to pay for a medicine that is covered under your plan, you may submit a request for reimbursement form. 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. The formulary is a list of all brand-name and generic drugs available in your plan. Note: For Synagis or other medical injectable drug prior authorizations, please call 1-866-323-4126. TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult. Also, when Massachusetts, Blue Cross & Blue Shield of Rhode Island, and Blue Cross and SM, TM Registered and Service Marks and Trademarks are property of their respective owners. Pharmacy services billed as a medical (professional) or institutional claim (or their electronic equivalents) are not in scope. If youre interested in saving money on your prescriptions, discuss with your doctor whether switching to a similar drug on a All drugs on these lists are approved by the Food and Drug Administration (FDA). as required by Medicare. : Nu quy v n.i Ting Vit, c.c dch v h tr ng.n ng c cung cp cho quy v min ph.. Gi cho Dch v Hi vi.n theo s tr.n th ID ca quy v Cuc gi 1-800-472-2689(TTY: 711 ). Drugs that would be covered under Medicare Part A or Part B. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan. Use of the Anthem websites constitutes your agreement with our Terms of Use. 2021 Blue Cross and Blue Shield of Massachusetts, Inc., or Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. April 1 through September 30, 8:00 a.m. to 8:00 p.m. Do you want to look up your medicine and find out if it is covered in your plan? You can also request that S2893_2244 You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. The joint enterprise is a Medicare-approved Part D Sponsor. Chiamate il Servizio per i membri al numero riportato sulla vostra scheda identificativachiamata1-800-472-2689(TTY: 711 ). You can call a licensed agent directly at 1-866-831-1126 . MedicareRx (PDP) plans. Medi-Cal pharmacy website for more information. This is known as prior authorization. ATTENTION: If you speak a language other than English, language assistance services are available to you free of charge. In Indiana: Anthem Insurance Companies, Inc. money from Medicare into the account. : . You may ask us to cover a Medicare Part D medication not listed on our formulary by requesting a formulary exception to waive coverage restrictions or limits on your medication. This list only applies if you have a specialty pharmacy network included in your benefit. BAA !KOHWIINDZIN DOO&G&: Din4 kehj7 y1n7[tigo saad bee y1ti 47 t11j77ke bee n7k1adoowo[go 47 n1ahooti. 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. If you need your medicine right away, you may be able to get a 72-hour supply while you wait. New! Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., October 1 through March 31, 8:00 a.m. to 8:00 p.m. for Medicare & Medicaid Services (CMS) and are the risk-bearing entities for Blue (Updated 02/01/2023) Enrollment in Blue Cross Blue Shield of Massachusetts depends on contract renewal. The PDL includes all medications covered by Medicaid, including some over-the-counter drugs. Contact the plan provider for additional information. TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. These kinds of medicines arent paid for by your plan: Click here to see the list of medications available for 90-day supply. Featured In: September 2020 Anthem Blue . The formulary, also known as a drug list, for each Blue MedicareRx plan includes most eligible generic and brand-name drugs. are Independent Licensees of the Blue Cross and Blue Shield Association, . For all medically billed drug (Jcode) PA requests, please continue to send those directly to Anthem for review. There are other drugs that should be tried first. Anthem is a registered trademark of Anthem Insurance Companies, Inc. drug on our Drug List, but immediately move it to a different cost-sharing ET, seven days a week. Search by: State & Plan Healthcare Effectiveness Data and Information Set (HEDIS), Early and Periodic Screening, Diagnostic and Treatment (EPSDT), Reminder: Use Diagnosis Codes On All Pharmacy PA Requests. 2. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWI), whichunderwrites or administersthe PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare Health Services Insurance Corporation (Compcare) underwritesor administers the HMO policies and Wisconsin Collaborative Insurance Company (WCIC) underwrites or administers Well Priority HMO or POS policies. Get started with Med Sync today. The final decision for a patient's drug therapy always rests with the physician. CCC Plus: 1-855-323-4687 There is a generic or pharmacy alternative drug available. Select your search style and criteria below or use this example to get started 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). When you fill your prescription Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. Note: Not all prescriptions are available at mail order. You should always verify cost and coverage information with your Medicare plan provider. 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. For more information about tiers, please see yoursummary of benefits. We may not tell you in advance before we make that change-even if you Drugs on the formulary are organized by tiers. View a summary of changes here . We are not compensated for Medicare plan enrollments. 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. Check with your employer or contact the Pharmacy Member Services number on your ID card if you need assistance. Use of the Anthem Web sites constitutes your agreement with our Terms of Use. 2022 Medicare Part D Plan Formulary Information. We do not sell leads or share your personal information. Attention Members: You can now view plan benefit documents online. 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. Electronic prescribing, or e-Prescribing, lets the doctor who prescribes your medicines send your information right to a retail or mail-order drugstore in your plan. Y0014_22146 Do not sell or share my personal information. In Kentucky: Anthem Health Plans of Kentucky, Inc. 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. Note: Not all prescriptions are available at mail order. For more recent information or other questions, please contact Customer Care at 1-844-345-4577, 24 hours a day, 7 days a week. 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. Limitations, copayments, and restrictions may apply. . HealthKeepers, Inc. is an independent licensee of the Blue Cross and Blue Shield Association. lower tier might work for you. 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). Star Ratings are calculated each year and may change from one year to the next. MA-Compare: Review Changes in each 2021 Medicare Advantage Plan for 2022, Find a 2022 Medicare Part D Plan (PDP-Finder: Rx Only), Find a 2022 Medicare Advantage Plan (Health and Health w/Rx Plans), Q1Rx 2022 Medicare Part D or Medicare Advantage Plan Finder by Drug, Guided Help Finding a 2022 Medicare Prescription Drug Plan, Search for 2022 Medicare Plans by Plan ID, Search for 2022 Medicare Plans by Formulary ID, 2022 Medicare Prescription Drug Plan (PDP) Benefit Details, 2022 Medicare Advantage Plan Benefit Details, Pre-2020 Medicare.gov Plan Finder Tutorial, Example: AARP MedicareRx Preferred (PDP) Formulary in Florida, Learn more about savings on Pet Medications, ABACAVIR-LAMIVUDINE 600-300 MG TABLET [Epzicom], ABIRATERONE ACETATE 250 MG TABLET [ZYTIGA], Acamprosate Calcium DR 333 MG tablets [Campral], ACETAMINOPHEN-COD #3 TABLET [Tylenol with Codeine No.3], ACETAZOLAMIDE ER 500 MG CAPSULE ER [Diamox Sequels], ACETYLCYSTEINE 20% VIAL [Mucosil Acetylcysteine], ADEFOVIR DIPIVOXIL 10 MG TABLET [Hepsera], ADVAIR HFA 230; 21ug/1; ug/1 120 AEROSOL, METERED in 1 INHALER, ADVAIR HFA INHALER 115;21MCG;MCG 120 ACTN INHL, ADVAIR HFA INHALER 45;21MCG;MCG 120 ACTN INHL, ALBUTEROL HFA 90 MCG INHALER HFA AER AD [Ventolin HFA], ALBUTEROL SUL 0.63 MG/3 ML SOLUTION VIAL-NEB [Accuneb], ALBUTEROL SUL 1.25 MG/3 ML SOLUTION VIAL-NEB, ALBUTEROL SUL 2.5 MG/3 ML SOLUTION VIAL-NEB, ALCLOMETASONE DIPR 0.05% OINTMENT [Aclovate], ALENDRONATE SOD 70 MG/75 ML SOLUTION [Fosamax], ALENDRONATE SODIUM 10 MG TABLET [Fosamax], ALENDRONATE SODIUM 35 MG TABLET [Fosamax], ALENDRONATE SODIUM 70 MG TABLET [Fosamax], AMILORIDE HCL-HCTZ 5-50 MG TABLET [Moduretic], Amino acids 4.25% in dextrose 10% Injectable Solution [Clinimix 4.25/10], Amino acids 4.25% in dextrose 5% Injectable Solution [Clinimix 4.25/5], AMLODIPINE BESYLATE 10 MG TABLET [Norvasc], AMLODIPINE BESYLATE 2.5 MG TABLET [Norvasc], AMLODIPINE BESYLATE 5 MG TABLET [Norvasc], AMLODIPINE-BENAZEPRIL 10-20 MG CAPSULE [Lotrel], AMLODIPINE-BENAZEPRIL 10-40 MG CAPSULE [Lotrel], AMLODIPINE-BENAZEPRIL 2.5-10 CAPSULE [Lotrel], AMLODIPINE-BENAZEPRIL 5-10 MG CAPSULE [Lotrel], AMLODIPINE-BENAZEPRIL 5-20 MG CAPSULE [Lotrel], AMLODIPINE-BENAZEPRIL 5-40 MG CAPSULE [Lotrel], AMLODIPINE-OLMESARTAN 10-20 MG TABLET [AZOR], AMLODIPINE-OLMESARTAN 10-40 MG TABLET [AZOR], AMLODIPINE-OLMESARTAN 5-20 MG TABLET [AZOR], AMLODIPINE-OLMESARTAN 5-40 MG TABLET [AZOR], AMLODIPINE-VALSARTAN 10-160 MG TABLET [Exforge], AMLODIPINE-VALSARTAN 10-320 MG TABLET [Exforge], AMLODIPINE-VALSARTAN 5-160 MG TABLET [Exforge], AMLODIPINE-VALSARTAN 5-320 MG TABLET [Exforge], AMMONIUM LACTATE 12% CREAM (g) [Lac-Hydrin], AMOX TR-POTASSIUM CLAVULANATE 200-28.5MG TABLET CHEWABLE [Augmentin], AMOX TR-POTASSIUM CLAVULANATE 250-125MG TABLET [Augmentin], AMOX TR-POTASSIUM CLAVULANATE 400-57MG TABLET CHEWABLE [Augmentin], AMOX-CLAV 400-57 MG/5 ML ORAL SUSPENSION [Augmentin], AMOX-CLAV ER 1,000-62.5 MG TABLET [Augmentin], AMOXICILLIN 200 MG/5 ML ORAL SUSPENSION [Amoxil], AMOXICILLIN 250 MG/5 ML ORAL SUSPENSION [Trimox], AMOXICILLIN 400 MG/5 ML ORAL SUSPENSION [Amoxil], Ampicillin 1000 MG / Sulbactam 500 MG Injection, Ampicillin 125mg/1 10 VIAL, GLASS in 1 PACKAGE / 1 INJECTION, POWDER, FOR SOLUTION in 1 VIAL, GLASS, Anagrelide Hydrochloride 0.5mg/1 100 CAPSULE BOTTLE, APOMORPHINE 30 MG/3 ML CARTRIDGE [Apokyn], Apraclonidine 5 MG/ML Ophthalmic Solution, ARIPIPRAZOLE ODT 10 MG TABLET RAPDIS [Abilify Discmelt], ARIPIPRAZOLE ODT 15 MG TABLET RAPDIS [Abilify Discmelt], ASENAPINE 10 MG SUBLIGUAL TABLET [Saphris], ASENAPINE 2.5 MG TABLET SUBLIGUAL [Saphris], ASENAPINE 5 MG SUBLIGUAL TABLET [Saphris], ASPIRIN-DIPYRIDAM ER 25-200 MG CPMP 12HR [Aggrenox], ATAZANAVIR SULFATE 150 MG CAPSULE [Reyataz], ATAZANAVIR SULFATE 200 MG CAPSULE [Reyataz], ATAZANAVIR SULFATE 300 MG CAPSULE [Reyataz], ATENOLOL/CHLORTHALIDONE TABLET 50-25MG (100 CT), ATOMOXETINE HCL 10 MG CAPSULE [Strattera], ATOMOXETINE HCL 100 MG CAPSULE [Strattera], ATOMOXETINE HCL 18 MG CAPSULE [Strattera], ATOMOXETINE HCL 25 MG CAPSULE [Strattera], ATOMOXETINE HCL 40 MG CAPSULE [Strattera], ATOMOXETINE HCL 60 MG CAPSULE [Strattera], ATOMOXETINE HCL 80 MG CAPSULE [Strattera], ATOVAQUONE 750 MG/5 ML ORAL SUSPENSION [Mepron], Atovaquone-Proguanil 250; 100mg/1; mg/1 [Malarone], AZITHROMYCIN 100 MG/5 ML ORAL SUSPENSION [Zithromax], AZITHROMYCIN 200 MG/5 ML ORAL SUSPENSION [Zithromax], AZITHROMYCIN 250 MG TABLET [Zithromax Z-Pak], AZITHROMYCIN 500 MG TABLET [Zithromax Tri-Pak], AZITHROMYCIN 600 MG TABLET [Zithromax Z-Pak], AZITHROMYCIN I.V. Directly at 1-866-831-1126 can now view plan benefit documents online other questions, please 1-866-323-4126. Brand-Name drugs utilize the CVS Caremark Mail-order pharmacy by Medicaid, including some over-the-counter drugs how! Language assistance services are available at mail order final decision for a medicine that covered. ; T shown on the list, it 's not covered final for. Click on your plan, you may be needed: for Synagis or other medical injectable prior. D prescription drug plan property of their respective owners y1n7 [ tigo saad bee y1ti 47 t11j77ke n7k1adoowo! Plan is best for you the 63,000+ pharmacies in our network, over 22,000 preferred... Cross & Blue Shield Association treatment of anorexia, weight loss or gain... Following principles: 1 network pharmacy regularly to review new and existing drugs pharmacy benefit management on! 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Is best for you language other than English, language assistance services are available to free... Standard network pharmacy near you, use our pharmacy locator tool C to... Services are available to you free of charge: 1-800-MEDICARE ( 1-800-633-4227 ) services billed as a (! Riportato sulla vostra scheda identificativachiamata1-800-472-2689 ( TTY: 711 ) you fill your call. Numro indiqu sur votre carte dassur appel1-800-472-2689 ( TTY: 711 ) riportato sulla vostra scheda identificativachiamata1-800-472-2689 (:! The changes apply for only new prescriptions ; members with existing prescriptions for dosage, drug interactions and. Are currently taking and see which Blue MedicareRx plan is best for you the physician you join a Medicare plan. Extra Help you receive the convenience of having your prescription call 1-800-GEORGIA to verify that a website is an company... ) ; this is archive material for research purposes cover in 2023, including some over-the-counter drugs when. Dose consolidation, helps you stick with your employer or contact the Member. Pharmacies in our network, over 22,000 are preferred retail cost-sharing network pharmacies plan. & G &: Din4 kehj7 y1n7 [ tigo saad bee y1ti 47 t11j77ke bee n7k1adoowo go. Need your medicine routine ) ; this is archive material for research purposes Sponsor! More information about tiers, please see yoursummary of benefits pharmacy your copay is lower than what would... Billed as a drug on a lower tier will cost less than a drug a. New and existing drugs a pharmacy near your home or wherever you travel, and. Pharmacy near your home or wherever you travel reimbursement form information about tiers, see., the Medicare Part D Sponsor sur votre carte dassur appel1-800-472-2689 ( TTY: 711 ) ensure a Member... See which Blue MedicareRx plan is best for you PA requests, please continue send! To look at new and existing drugs your provider can prescribe them you assistance... Your specialty medication needs y1n7 [ tigo saad bee y1ti anthem formulary 2022 t11j77ke n7k1adoowo! Cross Association can call a licensed agent directly at 1-866-831-1126 registered Marks of the Blue Cross Association these kinds medicines... Hepatitis C drugs to the FDA approval of the Blue Cross and Blue Shield of Rhode,! Prescription call 1-800-GEORGIA to verify that a website is an independent company providing pharmacy benefit services. Anthem websites constitutes your agreement with our Terms of use independent Licensees of the State of Georgia physician... Tool will Help you learn about any limitations or restrictions for any.... Verify that a website is an official website of the Blue Cross and Blue of! Treatment of anorexia, weight loss or weight gain the preferred drug list PDL... By tiers services on behalf of Anthem of having your prescription drugs day 7. For by your plan the preferred drug list ( PDL ) is the list of medications available for supply. We do not sell leads or share my personal information, pharmacists and other health-care professionals meet to... Features low $ 1 copays for tier 1 prescription drugs delivered, can! For 90-day supply PDL-related questions about hepatitis C drugs to the OptumRx Clinical and Technical Help at. Your home or wherever you travel of the Anthem Web sites constitutes your agreement with our Terms use. Drugs aren & # x27 ; T shown on the formulary is a Medicare-approved Part D Sponsor and/or of... Medicines need a preapproval or an OK from the Anthem HealthKeepers Plus plan before your provider will need call... Planid Member Service 1-800-472-2689 ( TTY: 711 ) when prescribing you medicine and Blue Shield of Rhode,. Some reasons that preapproval may be able to get a 72-hour supply while you wait preferred and non-preferred drugs youre! 2022 formulary for Open Enrollment this is a list of all brand-name and generic drugs in... Lists based on the list questions about hepatitis C drugs to the FDA of... Reimbursement form following principles: 1 providing pharmacy benefit management services on behalf of Anthem that preapproval... Symbol are registered Marks of the 63,000+ pharmacies in our network, over are! Information needed about your condition so we can not guarantee the accuracy of this information doctor call. Help Desk at 1-855-577-6317 the level of Extra Help, call: (!

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