'//cse.google.com/cse.js?cx=' + cx; This group meets regularly to review new and existing drugs, and to choose the top medications for our Drug List/Formulary. Your prescribing doctor has to approve this change to make sure its appropriate for your care. To submit electronic prior authorization (ePA) requests online, use Availity. An official website of the State of Georgia. ATTENZIONE: se parlate italiano, sono disponibili per voi servizi gratuiti di assistenza linguistica. In Kentucky: Anthem Health Plans of Kentucky, Inc. TTY users should call, 1-800-325-0778; or your state Medicaid Office. MedImpact is the pharmacy benefits manager. You can log in to your account and manage your prescriptions filled through home-delivery pharmacy. Blue MedicareRx Value Plus (PDP) and Blue MedicareRx Premier (PDP) are two When you fill your prescription at a preferred pharmacy your copay is lower . Blue Cross Blue Shield of Massachusetts Medicare Advantage Plans cover both brand name drugs and generic drugs. Providers may need to get approval from MedImpact for certain drugs. Learn more about Medicare formularies and find an Anthem Medicare Advantage Plan available near you that offers prescription drug coverage. Be sure to show the pharmacy your Anthem member ID card. If you need more medicine than the standard 34-day supply to treat a condition, you can ask us for prior authorization. In Indiana: Anthem Insurance Companies, Inc. For more information, contact the plan. However, the Medicare Part D plan data changes over time and we cannot guarantee the accuracy of this information. Medically necessary office-based injectables are covered under the major medical benefit. If you dont have Adobe Acrobat Reader, you can download a free copy by clicking HERE. 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 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. Featured In: You can talk to your pharmacist about coordinating your prescriptions to get started. Generic drugs have the same active ingredient formula as a brand name drug. 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. Note: For Synagis or other medical injectable drug prior authorizations, please call 1-866-323-4126. 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. 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). View a summary of changes here. are preferred retail cost-sharing network pharmacies. Products & Programs / Pharmacy. 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. Medallion Medicaid/FAMIS: 1-800-901-0020 'https:' : 'http:') + Cross and Blue Shield of Connecticut, Blue Cross Blue Shield of UWAGA: Osoby posugujce si jzykiem polskim mog bezpatnie skorzysta z pomocy jzykowej. Search by: State & Plan Express Scripts develops formularies based on the following principles: 1. S2893_2209 Page Last Updated 10/15/2022. Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont Attention Members: You can now view plan benefit documents online. 598-0820-PN-NE. The preapproval process helps us make sure that youre taking medications safely and correctly. Pharmacy services billed as a medical (professional) or institutional claim (or their electronic equivalents) are not in scope. If you use another pharmacy, you should tell the pharmacist about all medicines you are taking. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). 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. However, since our data is provided by Medicare, it is possible that this may not be a complete listing of plans available in your service Dietary supplements, except for treatment of phenylketonuria (PKU). The latest developments and submission guidelines from around the world are considered when developing and maintaining the drug list/formulary. Have more questions about Med Sync? Please note: The above plan information comes from CMS. Our. Independent licensees of the Blue Cross Association. IngenioRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Anthem. These requirements include: If you believe your use of a drug meets all special requirements, or that you should be exempt from a requirement, Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. Coverage is available to residents of the service area or members of an employer To ensure a smooth member transition and minimize costs, providers should review these changes and consider prescribing medications on formulary, if appropriate. IngenioRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Anthem. Enrollment in Blue MedicareRx (PDP) depends on contract renewal. Last Updated: 03/01/2023. Blue Cross of California is contracted with L.A. Care Health Plan to provide Medi-Cal Managed Care services in Los Angeles County. For more information contact the plan. Find an Anthem Medicare Advantage plan that offers prescription drug coverage. })(); This is archive material for research purposes. You can call a licensed agent directly at 1-866-831-1126 . See how we help keep your out-of-pocket costs low for the medications you and your family need. Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at, Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the. Compare Anthem Part D Plans MediBlue Rx* Standard Part D Plan This plan is a good choice if you take fewer medications. Independent licensees of the Blue Cross and Blue Shield Association. Small Group 2023 Select Drug List (Searchable) | (PDF) Small Group 2022 Select Drug List (Searchable) | (PDF) Espaol. Clicking on the therapeutic class of the drug. 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. Sep 1, 2022 Dose optimization, or dose consolidation, helps you stick with your medicine routine. 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. 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. We may not tell you in advance before we make that change-even if you 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. Blue MedicareRx formularies may change during a calendar year if we remove a drug, change a drugs tier, Work with your pharmacist so you can stick to a medicine routine. Enrollment in Blue Cross Blue Shield of Massachusetts depends on contract renewal. To ensure a smooth member transition and minimize costs, providers should review these changes and consider prescribing medications on formulary, if appropriate. Its easy when you use our search tool. are the legal entities which have contracted as a joint enterprise with the Centers Providers who do not contract with the plan are not required to see you except in an emergency. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan. Limitations, copayments, and restrictions may apply. Most prescriptions can be written with refills. Medicare Prescription Drug Plans available to service residents of Connecticut, The plan deposits LU . The request should include why a specific drug is needed and how much is needed. Contact the Pharmacy Member Services number on your ID card if you need assistance. 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. All the drugs we cover are carefully selected to provide the greatest value while meeting the needs of our members. 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. 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. Use of the Anthem websites constitutes your agreement with our Terms of Use. Member Service 1-800-472-2689(TTY: 711). We rely on objective evaluations from independent physicians. area. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. Please see PDPFinder.com or MAFinder.com for current plans. The benefit information provided is a brief summary, not a complete description of benefits. PAUNAWA: Kung nagsasalita ka ng wikang Tagalog, mayroon kang magagamit na mga libreng serbisyo para sa tulong sa wika. 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). Brief summary, not anthem formulary 2022 complete description of benefits your Anthem member ID card if you take fewer medications optimization... Sure to show the pharmacy member services number on your ID card that youre medications. Is archive material for research purposes prescribing medications on formulary, if appropriate or electronic. From MedImpact for certain drugs of this information about coordinating your prescriptions filled through home-delivery pharmacy serbisyo para tulong. Cross Life and Health Insurance company are independent licensees of the Blue of. Plans available to service residents of Connecticut, the Medicare Part D this! 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