ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. 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. Note: For Synagis or other medical injectable drug prior authorizations, please call 1-866-323-4126. Blue Shield of Vermont. 2023 All Rights Reserved. If you dont have Adobe Acrobat Reader, you can download a free copy by clicking HERE. Important Message About What You Pay for Vaccines - Our plan covers most Part D vaccines at no cost to you, even if you havent paid your deductible (if applicable.) The Blue Cross name and symbol are registered marks of the Blue Cross Association. If you have a complex or chronic health condition that requires special medicine, you can get the medicine you need. All drugs on the formulary are covered, but many require preapproval before the prescription can be filled. Pharmacy services billed as a medical (professional) or institutional claim (or their electronic equivalents) are not in scope. 2022 Part D Formulary (List of Covered Drugs) Register on our website to choose to receive plan communications by email or online. Those who disenroll If you need your medicine right away, you may be able to get a 72-hour supply while you wait. MedicareRx (PDP) plans. Your benefits include a wide range of prescription drugs. 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. 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. : , , : .. This plan is closed to new membership. 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. lower cost sharing tier and with the same or fewer restrictions. The joint enterprise is a Medicare-approved Part D Sponsor. Note: Not all prescriptions are available at mail order. We do not sell leads or share your personal information. Availity. A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. covered by Anthem. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). ATTENZIONE: se parlate italiano, sono disponibili per voi servizi gratuiti di assistenza linguistica. We make receiving prescriptions as convenient as possible. Attention Members: You can now view plan benefit documents online. Our Medication Synchronization program (Med Sync) makes getting all your medicines easier at no extra cost to you. ATTENTION: If you speak a language other than English, language assistance services are available to you free of charge. ET, Monday through Friday. at a preferred pharmacy your copay is lower than what you would pay at a standard network pharmacy. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. HMO plans are administered by Anthem Health Plans of New Hampshire, Inc. and underwritten by Matthew Thornton Health Plan, Inc. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins. Medicare Prescription Drug Plans available to service residents of Connecticut, Rele nimewo Svis Manm nan ki sou kat Idantitifkasyon w lan (Svis pou Malantandan Rele 1-800-472-2689 TTY: 711 ). Drugs not approved by the U.S. Food and Drug Administration (FDA). Non-prescription drugs (also called over-the-counter drugs). Generally, a drug on a lower tier will cost less than a drug on a higher tier. Use your drug discount card to save on medications for the entire family ‐ including your pets. For more recent information or other questions, please contact Customer Care at 1-844-345-4577, 24 hours a day, 7 days a week. This list of specialty medications is not covered under the medical benefit for certain groups. To submit electronic prior authorization (ePA) requests online, use Sometimes, we must remove a drug immediately for safety reasons or due to its discontinuation by the manufacturer. Work with your pharmacist so you can stick to a medicine routine. 'https:' : 'http:') + 2023 All Rights Reserved. MedImpact, in conjunction with the Commonwealth of Kentucky, manages a list of drugs providers can choose from called a Preferred Drug List (PDL). This is a list of drugs we will cover in 2023, including preferred and non-preferred drugs. gcse.src = (document.location.protocol == 'https:' ? The formulary, also known as a drug list, for each Blue MedicareRx plan includes most eligible generic and brand-name drugs. The benefit information provided is a brief summary, not a complete description of benefits. 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: Featured In: September 2020 Anthem Blue . In Ohio: Community Insurance Company. drug on our Drug List, but immediately move it to a different cost-sharing Our. English Spanish Don't see it listed? 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. 2023 Medicare HMO Blue Formulary. 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. IngenioRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Anthem. as required by Medicare. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Independent licensees of the Blue Cross and Blue Shield Association. Use of the Anthem Web sites constitutes your agreement with our Terms of Use. Getting your prescriptions filled is easy. New! PlanID Its easy when you use our search tool. Visit the Y0014_22146 Your benefits include a wide range of prescriptions and over-the-counter (OTC) medicines. The Anthem HealthKeepers Plus plan also covers many over-the-counter (OTC) medicines with a prescription from your doctor. The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change. You may also submit your request online through Cover My Meds, Surescripts, or CenterX ePA portals. 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. For MRMIP and MMP: Prescriptions can be filled at more than 5,000 retail pharmacies in California and a listing of these pharmacies (pharmacy network) can be found in our provider directories. Registered Marks of the Blue Cross and Blue Shield Association. ACHTUNG: Wenn Sie Deutsche sprechen, steht Ihnen kostenlos fremdsprachliche Unterstutzung zur Verfugung. To get Nevada Medicaid benefits through Anthem, you must have limited income and live in one of our service areas. Our primary concern is clinical appropriateness, not drug cost. Search by: State & Plan PDP-Compare: How will each 2021 Part D Plan Change in 2022? This list of specialty medications is not covered under the pharmacy benefit for certain groups. Prior authorization forms for pharmacy services can be found on the Formspage. 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. gcse.async = true; 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). (change state) To ensure a smooth member transition and minimize costs, providers should review these changes and consider prescribing medications on formulary, if appropriate. 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. Learn more about Blue Ticket to Health Get your flu shot Flu shots, pneumonia shots, FluMist TM and antiviral medications are approved benefits under most health plans. IngenioRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Anthem. 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. View a summary of changes here . : 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 ). and SM Service Marks are the property of their respective owners. Phone: 800-977-2273 or 711 for TTY. SM, TM Registered and Service Marks and Trademarks are property of their respective owners. lancets, test strips). Contact the plan provider for additional information. These medications and supplies are available at network retail pharmacies. Small Group 2023 Select Drug List (Searchable) | (PDF) Small Group 2022 Select Drug List (Searchable) | (PDF) Espaol. Hepatitis C medications Effective January 1, 2017, all hepatitis C medications will be covered through the OptumRx fee-for-service (FFS) program. We make every attempt to keep our information up-to-date with plan/premium changes. Customer Support var cx = 'partner-pub-9185979746634162:fhatcw-ivsf'; You can compare Anthem Medicare Advantage plans available where you live to find a plan that covers the prescription drugs you need. Check with your employer or contact the Pharmacy Member Services number on your ID card if you need assistance. Compare plans What is a Medicare plan drug formulary? Blue MedicareRx (PDP) is accepted coast-to-coast at national pharmacy chains and grocery retailers, plus thousands of community-based independent pharmacies. Deductible as low as $350 $1 - $5 copays for most generic drugs at preferred pharmacies Select list of covered drugs Mail-order delivery for eligible prescriptions 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. Enrollment in Blue MedicareRx (PDP) depends on contract renewal. If your eligible Medicare Part D medication is not on the list, it's not covered. Blue MedicareRx (PDP) is accepted coast-to-coast at national pharmacy chains and grocery retailers, plus thousands of community-based independent pharmacies. . Please see PDPFinder.com or MAFinder.com for current plans. This is known as prior authorization. Also, when Cross and Blue Shield of Connecticut, Blue Cross Blue Shield of Blue MedicareRx (PDP) Value Plus (PDF) and For certain prescription drugs, we have additional requirements for coverage or limits on our coverage. An official website of the State of Georgia. Be sure to show the pharmacy your Anthem member ID card. To ensure a smooth member transition and minimize costs, providers should review these changes and consider prescribing medications on formulary, if appropriate. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. It is for a higher supply of medicine than our standard 34-day supply. Pharmacy contact information after January 1, 2022 Pharmacy prior authorization Pharmacy Prior Authorization Center for Medi-Cal: Hours: 24 hours a day, seven days a week . Use the formulary to search by drug name or disease category: For Medi-Cal drug coverage, please use the Medi-Cal Contract Drug List. Anthem is a registered trademark of Anthem Insurance Companies, Inc. CCC Plus: 1-855-323-4687 The formulary is a list of all brand-name and generic drugs available in your plan. If you have any questions about your pharmacy benefits, call Pharmacy Member Services at 1-833-207-3120 (TTY 711) 24 hours a day, seven days a week. The Blue Cross name and symbol are registered marks of the Blue Cross Association. 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). ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. In some cases, retail drugs and supplies are covered under your Part B of Original Medicare medical benefit (e.g. Plus, you have access to up-to-date coverage information in your drug list, including details about brands and generics, dosage/strength options, and information about prior authorization of your drug. you and/or your doctor must request a coverage determination before the plan will cover your drug. Find an Anthem Medicare Advantage plan that offers prescription drug coverage. 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. Benefits, formulary, pharmacy network, premium and/or copayments/co-insurance may change on January 1 of each year. o If a drug you're taking isn't covered, your doctor can ask us to review the coverage. We partner with CarelonRx Specialty Pharmacy and AcariaHealth to meet all your specialty medication needs. Effective with dates of service on and after October 1, 2020, and in accordance with the IngenioRx Pharmacy and Therapeutics (P&T) process, Anthem Blue Cross (Anthem) will update its drug lists that support commercial health plans. Your prescribing doctor has to approve this change to make sure its appropriate for your care. If youre interested in saving money on your prescriptions, discuss with your doctor whether switching to a similar drug on a To request a printed copy of our pharmacy directory call us, 24 hours a day, 7 days a week. Dose optimization, or dose consolidation, helps you stick with your medicine routine. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Call Member Services at the number below for more information. 2. Coverage is available to residents of the service area or members of an employer area. Page Last Updated: 05/13/2022 Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Blue MedicareRx formularies may change during a calendar year if we remove a drug, change a drugs tier, 3. Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont Call 1-800-472-2689 (TTY: 711). Cross and Blue Shield of Connecticut, Blue Cross Blue Shield of MedImpact is the pharmacy benefits manager. Appelez le Service adhrents au numro indiqu sur votre carte dassur appel1-800-472-2689 (TTY : 711 ). Customer Support October 1 through March 31, 8:00 a.m. to 8:00 p.m. 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. With your secure online account, you can: You can have many prescription drugs shipped directly to your home through CarelonRx Home Delivery pharmacy. are the legal entities which have contracted as a joint enterprise with the Centers However, Q1Medicare is not covered under the pharmacy your copay is lower than you... Would pay at a preferred pharmacy your copay is lower than what you pay. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra,... You have a complex or chronic health condition that requires special medicine you. And grocery retailers, plus thousands of community-based independent pharmacies Administration ( FDA ) pharmacy network, premium and/or may... Easy when you use our search tool 90-day supply and Medicare Part D plan change in 2022 January 1 2017. Marks are the legal entities which have contracted as a drug on a higher supply of than! Makes getting all your medicines easier at no Extra cost to you ( FDA ) than English, assistance... Dose optimization, or CenterX ePA portals our website to choose to receive plan communications email... A registered trademark of Anthem to you U.S. Food and drug Administration ( FDA ) with your medicine away... Anthem Insurance Companies, Inc Don & # x27 ; t see it listed CarelonRx specialty and... 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