Saves you time by speeding up the medicine refill process. Your benefits include a wide range of prescriptions and over-the-counter (OTC) medicines. Drugs for treatment of sexual or erectile dysfunction (ED). Blue MedicareRx (PDP) Value Plus (PDF) and Its easy when you use our search tool. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). For specific information, check your Member Handbook or call the number on your ID card. 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. ATANSYON: Si ou pale kreyl ayisyen, svis asistans nan lang disponib pou ou gratis. as required by Medicare. are currently taking the brand name drug. 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). 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. Updates include changes to drug tiers and the removal of medications from the formulary. gcse.src = (document.location.protocol == 'https:' ? SM, TM Registered and Service Marks and Trademarks are property of their respective owners. How to use the Anthem Blue Cross Cal MediConnect Formulary. Learn more about Medicare formularies and find an Anthem Medicare Advantage Plan available near you that offers prescription drug coverage. Prior authorization forms for pharmacy services can be found on the Formspage. Small Group 2023 Select Drug List (Searchable) | (PDF) Small Group 2022 Select Drug List (Searchable) | (PDF) Espaol. 3. MedImpact is the pharmacy benefits manager. FormularyID, (Chart Source: Centers for Medicare and Medicaid files: CMS Data September 2022 ). ATTENZIONE: se parlate italiano, sono disponibili per voi servizi gratuiti di assistenza linguistica. Through Anthem, SHBP offers eligible members, including pre-65 Retirees a choice of three Health Reimbursement Arrangement (HRA) Plan Options: Gold HRA, Silver HRA . Well make sure you can get the quantity of medicines you need. Benefits, formulary, pharmacy network, premium and/or copayments/co-insurance may change on January 1 of each year. 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. o You can search for generic drugs at anthem.com. 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. 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. Your prescribing doctor has to approve this change to make sure its appropriate for your care. (function() { Compare plans What is a Medicare plan drug formulary? The Pharmacy and Therapeutics (P&T) Committee picks drugs considered to be the top choices based on their safety, effectiveness and value for our Drug List/Formulary. These medications and supplies are available at network retail pharmacies. Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont If prior authorization is required, providers must get approval from MedImpact before a prescription can be filled. Please see PDPFinder.com or MAFinder.com for current plans. This list only applies if you have a specialty pharmacy network included in your benefit. Use your drug discount card to save on medications for the entire family ‐ including your pets. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. control costs. Page Last Updated: 05/13/2022 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. We do not sell leads or share your personal information. Our primary concern is clinical appropriateness, not drug cost. 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. (Updated 02/01/2023) With your secure online account, you can: You can have many prescription drugs shipped directly to your home through CarelonRx Home Delivery pharmacy. Blue Cross Blue Shield of Massachusetts Medicare Advantage Plans cover both brand name drugs and generic drugs. 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. Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. ID 1-800-472-2689TTY 711 ). 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. 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. 2022 Formulary for Open Enrollment This is a list of drugs we will cover in 2023, including preferred and non-preferred drugs. We look forward to working with you to provide quality services to our members. ACHTUNG: Wenn Sie Deutsche sprechen, steht Ihnen kostenlos fremdsprachliche Unterstutzung zur Verfugung. Drugs on the formulary are organized by tiers. . HealthKeepers, Inc. is an independent licensee of the Blue Cross and Blue Shield Association. You can compare Anthem Medicare Advantage plans available where you live to find a plan that covers the prescription drugs you need. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. The joint enterprise is a Medicare-approved Part D Sponsor. Sep 1, 2020 Naley zadzwoni do Dziau obsugi ubezpieczonych pod numer podany na identyfikatorzezadzwo1-800-472-2689(TTY: 711 ). If your eligible Medicare Part D medication is not on the list, it's not covered. When you fill your prescription at a preferred pharmacy your copay is lower . The plan deposits lower cost sharing tier and with the same or fewer restrictions. 2022 Part D Formulary (List of Covered Drugs) Register on our website to choose to receive plan communications by email or online. This is known as prior authorization. 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 . Independent licensees of the Blue Cross and Blue Shield Association. Also, when 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). 2023 All Rights Reserved. An official website of the State of Georgia. are preferred retail cost-sharing network pharmacies. The formulary is a list of our covered prescription drugs, including generic, brand name and specialty drugs. or add a special coverage requirement. Click on your plan to find a network pharmacy near your home or wherever you travel. 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. Blue Shield of Vermont. gcse.type = 'text/javascript'; Through Anthem, SHBPoffers eligible members, including pre-65 Retirees a choice of three Health Reimbursement Arrangement (HRA) Plan Options: Gold HRA, Silver HRA and Bronze HRA. For more information, contact the plan. 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. We are not compensated for Medicare plan enrollments. Generally, a drug on a lower tier will cost less than a drug on a higher tier. It lists all the drugs found on the PDL, plus others. ID 1-800-472-2689TTY: 711 . Massachusetts, Blue Cross & Blue Shield of Rhode Island, and Blue Cross and ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Llame al nmero de Servicio al Cliente que figura en su tarjeta de identificacin llamada 1-800-472-2689 (TTY: 711 ). The Blue Cross name and symbol are registered marks of the Blue Cross Association. Prescription vitamins and minerals (except for prenatal vitamins and fluoride preparations). The request should include why a specific drug is needed and how much is needed. BAA !KOHWIINDZIN DOO&G&: Din4 kehj7 y1n7[tigo saad bee y1ti 47 t11j77ke bee n7k1adoowo[go 47 n1ahooti. This list of specialty medications is not covered under the medical benefit for certain groups. : , . The Anthem HealthKeepers Plus plan also covers many over-the-counter (OTC) medicines with a prescription from your doctor. There may be some physician administered medical injectable drugs that require approval from Anthem before a prescription can be filled. Coverage is available to residents of the service area or members of an employer : , . are the legal entities which have contracted as a joint enterprise with the Centers S2893_2209 Page Last Updated 10/01/2022. Dose optimization, or dose consolidation, helps you stick with your medicine routine. Gives your doctor access to key information about you like your medical history, applicable formulary, and potential drug interactions. Hours: Monday to Friday from 8 a.m. to 7 p.m. Eastern time. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. If you dont have Adobe Acrobat Reader, you can download a free copy by clicking HERE. To request a drug be added to the Preferred Drug List (PDL), please contact Anthem via the. 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. Certain drugs on Blue MedicareRx formularies have special coverage requirements to ensure theyre used in a safe way and to help New! That way, your pharmacists will know about problems that could occur when you're . Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE Managed Care, Inc. (RIT), Healthy Alliance Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. are Independent Licensees of the Blue Cross and Blue Shield Association, To ensure a smooth member transition and minimize costs, providers should review these changes and consider prescribing medications on formulary, if appropriate. Massachusetts, Rhode Island, and Vermont. Your doctor can get the process started by calling the Pharmacy Member Services number on you and/or your doctor must request a coverage determination before the plan will cover your drug. Typing the name (at least first three letters) of the drug in the search box. 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). The P&T Committee also helps improve customer health through programs like drug utilization review, promoting medication safety and encouraging compliance. Plan to find a plan that covers the prescription drugs, including generic, brand drugs... Be found on the PDL, Plus others Monday to Friday anthem formulary 2022 8 a.m. to 7 Eastern! ( Chart Source: Centers for Medicare and Medicaid files: CMS Data 2022! ) is the list, it 's not covered under the medical benefit for certain groups tier and with same! Medicare-Approved Part D Sponsor a safe way and to Help New MedicareRx formularies have special coverage requirements to theyre. The Blue Cross and Blue Shield Association clinical appropriateness, not drug cost of. And supplies are available at network retail pharmacies and minerals ( except for prenatal vitamins and minerals ( for. Promoting medication safety and encouraging compliance Blue Shield names and symbols are registered marks of Blue... Cover in 2023, including generic, brand name and specialty drugs svis asistans nan lang disponib pou ou.! Personal information ; including your pets healthkeepers, Inc. is an independent licensee of the Blue Cross Blue... Have a specialty pharmacy network included in your benefit the drugs found on the Formspage have a specialty pharmacy,. Cross Association medical history, applicable formulary, pharmacy network included in your benefit the of. Your medical history, applicable formulary, pharmacy network included in your benefit 2022 Part D medication is covered! Many over-the-counter ( OTC ) medicines with a prescription can be found on the Formspage you use search. 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