Blue MedicareRx Value Plus (PDP) and Blue MedicareRx Premier (PDP) are two The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Limitations, copayments, and restrictions may apply. Anthem is a registered trademark of Anthem Insurance Companies, Inc. Dietary supplements, except for treatment of phenylketonuria (PKU). Drugs for treatment of anorexia, weight loss or weight gain. We may not tell you in advance before we make that change-even if you Call 1-800-901-0020 (TTY 711). If a medication does not appear on this formulary, a prescription drug prior authorization form will need to be completed by the prescriber and submitted to Anthem Blue Cross (Anthem) before the prescription may be filled. 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. Formularies 2023 FEP Blue Focus Formulary View List 2023 Basic Option Formulary View List 2023 Standard Option Formulary View List Drug tiers 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. However, the Medicare Part D plan data changes over time and we cannot guarantee the accuracy of this information. Independent licensees of the Blue Cross and Blue Shield Association. The PDL includes all medications covered by Medicaid, including some over-the-counter drugs. 598-0820-PN-NE. Our Medication Synchronization program (Med Sync) makes getting all your medicines easier at no extra cost to you. TTY users should call 711. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. dba HMO Nevada. For all medically billed drug (Jcode) PA requests, please continue to send those directly to Anthem for review. Gives your doctor access to key information about you like your medical history, applicable formulary, and potential drug interactions. If you misplace your medicine or it is stolen, contact your provider. If youre interested in saving money on your prescriptions, discuss with your doctor whether switching to a similar drug on a Our. ET, Monday through Friday. Tier assignments vary by plan. 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. })(); This is archive material for research purposes. 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. If a change affects a drug you take, we will notify you at least 60 days in advance, 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. To verify Medi-Cal pharmacy network participation or pharmacy drug coverage under Medi-Cal, please call the Pharmacy Benefits Manager: The Anthem Blue Cross Cal MediConnect Plan Formulary lists the brand name or generic name of a given drug. Massachusetts, Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Make sure you have your medicines when you need them. To conduct a search, enter the Medication Name or select a Therapeutic Category or TherapeuticClass. Blue Cross and Blue Shield of Massachusetts is an HMO and PPO Plan with a Medicare contract. You can fill your prescriptions at more than 5,000 retail pharmacies in your plan across Virginia. 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. Drugs for treatment of sexual or erectile dysfunction (ED). Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont Pharmacy services billed as a medical (professional) or institutional claim (or their electronic equivalents) are not in scope. Attention Members: You can now view plan benefit documents online. Visit theAppeals & Grievancessection for more information. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. However, they do not qualify for exception requests, extra help on drug costs,transition fills, or accumulate toward your total out of pocket costs to bring you through the coverage gap faster like drugs covered under your Medicare prescription drug benefit. View the upcoming formulary changes for An official website of the State of Georgia. 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. That way, your pharmacists will know about problems that could occur when you're . Anthem MediBlue Rx Plus (PDP) (S5596-057-0) Benefit Details. Contact the Pharmacy Member Services number on your ID card if you need assistance. PDP-Compare: How will each 2021 Part D Plan Change in 2022? They will work with the pharmacy and the Anthem HealthKeepers Plus plan to review your case and replace your medicines as needed. To request a printed copy of our pharmacy directory call us, 24 hours a day, 7 days a week. You can call a licensed agent directly at 1-866-831-1126 . 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. Please contact the plan for further details. 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. Also, when The Anthem HealthKeepers Plus plan will review the request and give a decision within 24 hours. If you are a member with Anthems pharmacy coverage, click on the link below to log in and automatically connect to the drug list that applies to your pharmacy benefits. Enrollment in Blue MedicareRx (PDP) depends on contract renewal. 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. It is for a higher supply of medicine than our standard 34-day supply. The plan deposits To ensure a smooth member transition and minimize costs, providers should review these changes and consider prescribing medications on formulary, if appropriate. FormularyID, (Chart Source: Centers for Medicare and Medicaid files: CMS Data September 2022 ). Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., Healthcare Effectiveness Data and Information Set (HEDIS), Early and Periodic Screening, Diagnostic and Treatment (EPSDT), Reminder: Use Diagnosis Codes On All Pharmacy PA Requests. See how we help keep your out-of-pocket costs low for the medications you and your family need. October 1 through March 31, 8:00 a.m. to 8:00 p.m. ACHTUNG: Wenn Sie Deutsche sprechen, steht Ihnen kostenlos fremdsprachliche Unterstutzung zur Verfugung. Massachusetts, Rhode Island, and Vermont. Please see PDPFinder.com or MAFinder.com for current plans. The joint enterprise is a Medicare-approved Part D Sponsor. Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont 2022 Formulary for Open Enrollment This is a list of drugs we will cover in 2023, including preferred and non-preferred drugs. In certain situations, you can. tier or add new restrictions. : . This plan covers select insulin pay $35 copay. covered by Anthem. 500 MG VIAL [Zithromax], Everyone in your household can use the same card, including your pets. The request should include why a specific drug is needed and how much is needed. MedImpact, in conjunction with the Commonwealth of Kentucky, manages a list of drugs providers can choose from called a Preferred Drug List (PDL). 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. Registered Marks of the Blue Cross and Blue Shield Association. 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). We may immediately remove a brand name drug on our Drug List if we 2023 Medicare HMO Blue Formulary. and SM Service Marks are the property of their respective owners. Click on your plan to find a network pharmacy near your home or wherever you travel. For specific information, check your Member Handbook or call the number on your ID card. 1-800-472-2689 (TTY : 711) . This tool will help you learn about any limitations or restrictions for any rug. 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 preferred retail cost-sharing network pharmacies. If you need your medicine right away, you may be able to get a 72-hour supply while you wait. . Last Updated: 03/01/2023. 1-800-472-2689(TTY: 711). Most prescriptions can be written with refills. Appelez le Service adhrents au numro indiqu sur votre carte dassur appel1-800-472-2689 (TTY : 711 ). ZIP & Plan Its good to use the same pharmacy each time you fill a prescription. 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 latest developments and submission guidelines from around the world are considered when developing and maintaining the drug list/formulary. Your prescribing doctor has to approve this change to make sure its appropriate for your care. Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., You can compare Anthem Medicare Advantage plans available where you live to find a plan that covers the prescription drugs you need. These kinds of medicines arent paid for by your plan: Click here to see the list of medications available for 90-day supply. To request a drug be added to the Preferred Drug List (PDL), please contact Anthem via the. or union group and separately issued by one of the following plans: Anthem Blue This list is for members who have the Medicare Supplement Senior SmartChoice plan. Getting your prescriptions filled is easy. 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. Simply take your written prescription to a plan pharmacy or ask your doctor to call it in. Products & Programs / Pharmacy. Certain generic drugs that are available at the lowest copayment for our members, Higher cost generic drugs available at a higher copayment than Tier 1 generic drugs, Common brand-name and some higher cost generic drugs, High cost generic and non-preferred drugs, many of which may have lower cost options available on Tier 1, 2 or 3, Unique and/or very high-cost brand and some generic drugs of which you pay a percentage of the drug cost; some may require special handling and/or close monitoring, Prior authorization you will need to obtain approval before you fill your prescription, Quantity limit There is a limit to the amount of the drug the plan will cover with each prescription filled, Step therapy You may be required to try an alternative drug before this drug is covered, Limited access This prescription may be available only at certain pharmacies. Use of the Anthem websites constitutes your agreement with our Terms of Use. Get the mobile app 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 currently taking the brand name drug. Benefits, formulary, pharmacy network, premium and/or copayments/co-insurance may change on January 1 of each year. Use this form to set up home delivery for your prescriptions. Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont Enrollment in Blue MedicareRx (PDP) depends on contract renewal. Dose optimization, or dose consolidation, helps you stick with your medicine routine. You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. If you have the PreventiveRx Drug List (Preferred), please refer to the PreventiveRx Plus Drug List (National) above. The Blue Cross name and symbol are registered marks of the Blue Cross Association. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). 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. BAA !KOHWIINDZIN DOO&G&: Din4 kehj7 y1n7[tigo saad bee y1ti 47 t11j77ke bee n7k1adoowo[go 47 n1ahooti. IngenioRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Anthem. (Updated 02/01/2023) (ID Card) 1-800-472-2689(TTY: 711 ). Before sharing sensitive or personal information, make sure youre on an official state website. Anthem Blue Cross is the trade name of Blue Cross of California. Blue MedicareRx (PDP) is a Prescription Drug Plan with a Medicare contract. Coverage is available to residents of the service area or members of an employer 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. We have two drug lists that show which drugs are in your plan. The drug has a high side effect potential. You can also learn more about some of our online tools, like pricing a drug, by clicking on the link to the video. Express Scripts develops formularies based on the following principles: 1. Use of the Anthem Web sites constitutes your agreement with our Terms of Use. To submit electronic prior authorization (ePA) requests online, use Availity. Type at least three letters and we will start finding suggestions for you. 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 Anthem MediBlue Rx Plus (PDP) (S5596-057-0) Formulary Drugs Starting with the Letter A. in CMS PDP Region 16 which includes: WI. Drugs for cosmetic purposes or hair growth. : , . Customer Support A doctor can also call in the prescription for you. 1-800-472-2689(TTY: 711) . Note: Not all prescriptions are available at mail order. 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. lower cost sharing tier and with the same or fewer restrictions. 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. 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. All drugs on the formulary are covered, but many require preapproval before the prescription can be filled. Sep 1, 2020 We offer an outcomes-based formulary. control costs. We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. In some cases, retail drugs and supplies are covered under your Part B of Original Medicare medical benefit (e.g. 2022 Medicare Part D Plan Formulary Information. 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). Limitations, copayments, and restrictions may apply. '//cse.google.com/cse.js?cx=' + cx; The formulary is a list of our covered prescription drugs, including generic, brand name and specialty drugs. 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. Your benefits include a wide range of prescriptions and over-the-counter (OTC) medicines. OTC drugs aren't shown on the list. Some medicines need a preapproval or an OK from the Anthem HealthKeepers Plus plan before your provider can prescribe them. Attention Members: You can now view plan benefit documents online. Contact the Medicare plan for more information. The formulary, also known as a drug list, for each Blue MedicareRx plan includes most eligible generic and brand-name drugs. Do you want to look up your medicine and find out if it is covered in your plan? Contact Anthem Blue Cross and Blue Shield. We work with CarelonRx to provide these pharmacy benefits. Your Medicare Part D prescription benefit is a 5-tier structure. Use the formulary to search by drug name or disease category: For Medi-Cal drug coverage, please use the Medi-Cal Contract Drug List. When you fill your prescription This is known as prior authorization. Visit the You may also submit your request online through Cover My Meds, Surescripts, or CenterX ePA portals. Medicare has neither reviewed nor endorsed the information on our site. Please note, this update does not apply to the Select Drug List and does not affect Medicaid and Medicare plans. Registered Marks of Blue Cross and Blue Shield of Massachusetts, Inc., and Blue Cross and Blue Shield of Massachusetts HMO Blue, Inc. Registered Marks, TM Trademarks. View a summary of changes here . Off-label drug use, which means using a drug for treatments not specifically mentioned on the drugs label. It features low $1 copays for tier 1 prescription drugs. 634-0920-PN-CONV. 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. The drug is prescribed at a higher dosage than recommended. 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. gcse.async = true; 2023 All Rights Reserved. The final decision for a patient's drug therapy always rests with the physician. This process is called preapproval or prior authorization. ID 1-800-472-2689TTY 711 ). ATTENZIONE: se parlate italiano, sono disponibili per voi servizi gratuiti di assistenza linguistica. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia con el idioma. Members may enroll in a Medicare Advantage plan only during specific times of the year. All the drugs we cover are carefully selected to provide the greatest value while meeting the needs of our members. If you use another pharmacy, you should tell the pharmacist about all medicines you are taking. LU . 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. These medications and supplies are available at network retail pharmacies. o You can search for generic drugs at anthem.com. The P&T Committee also helps improve customer health through programs like drug utilization review, promoting medication safety and encouraging compliance. Important Message About What You Pay for Insulin - You wont pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier its on even if you havent paid your deductible, if applicable. State of Georgia government websites and email systems use georgia.gov or ga.gov at the end of the address. To get Nevada Medicaid benefits through Anthem, you must have limited income and live in one of our service areas. Medicare MSA Plans do not cover prescription drugs. Blue MedicareRx (PDP) is accepted coast-to-coast at national pharmacy chains and grocery retailers, plus thousands of community-based independent pharmacies. : , , . Drugs to relieve a cough or cold symptoms. Learn more about Medicare formularies and find an Anthem Medicare Advantage Plan available near you that offers prescription drug coverage. This group meets regularly to review new and existing drugs, and to choose the top medications for our Drug List/Formulary. The preapproval process helps us make sure that youre taking medications safely and correctly. TTY 711 We are not affiliated with any Medicare plan, plan carrier, healthcare provider, or insurance company. If a sudden removal occurs, we will notify our affected members as soon as possible. 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. Sep 1, 2022 In Indiana: Anthem Insurance Companies, Inc. IngenioRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Anthem. 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. 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. Call to speak with a licensed insurance agent and find plans in your area. 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. during the calendar year will owe a portion of the account deposit back to the plan. Your doctor can prescribe most of these medicines to you without getting preapproval or an OK from us. : , , : .. In Connecticut: Anthem Health Plans, Inc. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). are replacing it with a new generic drug that will appear on the same or For more information about tiers, please see yoursummary of benefits. money from Medicare into the account. (change state) Sometimes, we must remove a drug immediately for safety reasons or due to its discontinuation by the manufacturer. These requirements include: If you believe your use of a drug meets all special requirements, or that you should be exempt from a requirement, Customer Support Also, displayed are some medications and supplies covered under your Part B of Original Medicare medical benefit. * IngenioRx, Inc. is an independent company providing pharmacy benefit management services and some utilization review services on behalf of Anthem Blue Cross and Blue Shield. 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. Specific times of the Blue Cross is the trade name of Blue Cross.. Will each 2021 Part D prescription benefit is a prescription: Si habla espaol, tiene a disposicin... Or wherever you travel from the Anthem HealthKeepers Plus plan before your provider or ga.gov at the of... Contact Anthem via the of each year doctor to call it in form to set up delivery... About any limitations or restrictions for any rug encouraging compliance drug lists that show which drugs are in your can..., we must remove a drug immediately for safety reasons or due to its discontinuation by manufacturer! Requests online, use Availity shown on the List of medications available for supply... Name of Blue Cross and Blue Shield Association parlate italiano, sono disponibili per servizi... Vial [ Zithromax ], Everyone in your plan: click here to see if you have PreventiveRx... And all other drugs are limited to a 34-day supply over-the-counter drugs prescription drugs except! Set up home delivery for your prescriptions, discuss with your medicine routine switching to a plan pharmacy ask. To enroll in a Medicare Advantage plan only during specific times of the of! Limitations or restrictions for any rug grocery retailers, Plus thousands of community-based independent pharmacies it features low $ copays! Research purposes de asistencia con el idioma HMO products underwritten by HMO Colorado Inc.. For you following principles: 1 call a licensed insurance agent and find Anthem... Each time you fill a prescription a patient & # x27 ; t shown the.: Rocky Mountain Hospital and medical Service, Inc. dba HMO Nevada programs like utilization! Stick with your medicine routine could occur when you fill a prescription drug coverage a Preferred pharmacy your copay lower... Advantage plan only during specific times of the Blue Cross Association plan data changes over time and we will finding... Getting preapproval or an OK from the Anthem HealthKeepers Plus plan will review the request include. Medicare Advantage plans cover both brand name drugs and supplies are covered under your Part B Original... Behalf of Anthem insurance Companies, Inc. HMO products underwritten by HMO Colorado, Inc. is an official website the... Medicare plans plan includes most eligible generic and brand-name drugs value while meeting needs... Removal occurs, we must remove a drug List ( Preferred ), please use the same or fewer.. For an official website of the Anthem Web sites constitutes your agreement with our of... Preferred pharmacy your copay is lower ePA ) requests online, use.... Has to approve this change to make sure youre on an official state website My,. The latest developments and submission guidelines from around the world are considered when developing and maintaining the list/formulary... Using a drug List customer health through programs like drug utilization review, promoting Medication safety and encouraging compliance for... Or Medicare Advantage plans cover both brand name drug on our site or at! Pku ) all drugs on the following principles: 1 you use another pharmacy, you must enrolled! Healthcare provider, or insurance company good to use the formulary, known., 7 days a week supplies are covered, but anthem formulary 2022 require preapproval before prescription. Tier and with the physician over time and we will notify our members... Need a preapproval or an OK from the Anthem HealthKeepers Plus plan will review request. Or erectile dysfunction ( ED ) written prescription to a 34-day supply drug ( )! Of anorexia, weight loss or weight gain dba HMO Nevada in Nevada: Rocky Hospital... Drug is prescribed at a higher dosage than recommended time you fill a prescription drug plan with a Medicare plan... All medications covered by Medicaid, including your pets most eligible generic and brand-name.! Category or TherapeuticClass group meets regularly to review your case and replace your medicines at. Pharmacy each time you fill your prescriptions at more than 5,000 retail pharmacies your. Copayments/Co-Insurance may change on January 1 of each year carefully selected to provide these pharmacy benefits is the trade of... On an official website of the state of Georgia to speak with a Medicare.. ( S5596-057-0 ) benefit Details of these medicines to you without getting preapproval or an OK from the HealthKeepers... May immediately remove a drug immediately for safety reasons or due to its by... You are taking plan: click here to see the List retailers, Plus thousands of independent... In Blue MedicareRx ( PDP ) is a Medicare-approved Part D plan change in?... 24 hours of Original Medicare medical benefit ( e.g an HMO and PPO plan with a Medicare.. Before we make that change-even if you misplace your medicine routine in the for... Type at least three letters and we will start finding suggestions for you plan carrier healthcare..., applicable formulary, also known as prior authorization ( ePA ) requests online, Availity. Any rug, tiene a su disposicin servicios gratuitos de asistencia con el.... We make every effort to show all available Medicare Part D plan data over. Carelonrx to provide the greatest value while meeting the needs of our pharmacy directory call us 24... Card if you qualify for Extra help, call: 1-800-MEDICARE ( 1-800-633-4227 ) plan with a Medicare plans! Covers select insulin pay $ 35 copay Inc. Dietary supplements, except for treatment phenylketonuria!, use Availity through cover My Meds, Surescripts, or insurance company con el idioma votre carte dassur (!, healthcare provider, or dose consolidation, helps you stick with your doctor to call it.! Switching to a plan pharmacy or ask your doctor to call it in, you can now plan... Mountain Hospital and medical Service, Inc. dba HMO Nevada your Member Handbook or call the number on your card! Must be enrolled in both Medicare Part D Sponsor a day, 7 days a week Inc. is an website! Medications available for a patient & # x27 ; s drug therapy always rests the!: CMS data September 2022 ) to key information about you like your medical history, applicable formulary, known. With your medicine right away, you can now view plan benefit documents online Blue Shield of Medicare! Not affiliated with any Medicare plan, plan carrier, healthcare provider, or CenterX portals! ; t shown on the formulary, and to choose the top for! Some medicines need a preapproval or an OK from us to Anthem for review card you. The prescription can be filled disposicin anthem formulary 2022 gratuitos de asistencia con el idioma customer a. T shown on the List of medications available for 90-day supply we 2023 Medicare HMO formulary! Please refer to the select drug List if we 2023 Medicare HMO Blue formulary x27 ; t shown on drugs. Drug interactions independent pharmacies authorization ( ePA ) requests online, use Availity, Inc. is official. Why a specific drug is needed Marks of the state of Georgia websites. Our pharmacy directory call us, 24 hours a day, 7 days week. Require preapproval before the prescription for you plan to review new and existing drugs, and potential interactions. & plan its good to use the same pharmacy each time you fill prescription. Family need disponibili per voi servizi gratuiti di assistenza linguistica preapproval before the can... Added to the select drug List and does not apply to the select drug List National! Of these medicines to you, pharmacy network, premium and/or copayments/co-insurance may on! A plan pharmacy or ask your doctor can also call in the prescription can be filled members as soon possible! Higher dosage than recommended take your written prescription to a similar drug on a our way your... When the Anthem HealthKeepers Plus plan before your provider benefit documents online HMO Nevada your benefits include wide... That youre taking medications safely and correctly prescription benefit is a registered trademark of Anthem insurance Companies, Inc. see... A Therapeutic Category or TherapeuticClass to enroll in a Medicare contract in advance before we make that if... On a our two drug lists that show which drugs are in your household can use same. Sync ) makes getting all your medicines as needed email systems use or! Can call a licensed agent directly at 1-866-831-1126 24 hours a day, 7 days week. Learn about any limitations or restrictions for any rug ) is accepted coast-to-coast National. We help keep your out-of-pocket costs low for the medications you and your family need call 1-800-GEORGIA to verify a... Your Medicare Part D or Medicare Advantage plans in your area anthem formulary 2022 one our! Getting all your medicines easier at no Extra cost to you without getting preapproval or an OK from the Web..., 2020 we offer an outcomes-based formulary you call 1-800-901-0020 ( TTY: 711 ) restrictions any... Service area like drug utilization review, promoting Medication safety and encouraging compliance su servicios... Drug on a our you must be enrolled in both Medicare Part D Sponsor Medi-Cal contract drug (... Like drug utilization review, promoting Medication safety and encouraging compliance encouraging compliance plan carrier, provider... Sure that youre taking medications anthem formulary 2022 and correctly approve this change to make sure that youre taking safely! Anorexia, weight loss or weight gain more about Medicare formularies and find an Anthem Medicare Advantage plan only specific! Before sharing sensitive or personal information, make sure that youre taking medications safely and correctly how will 2021! Should tell the pharmacist about all medicines you are taking in 2022 ) Sometimes we! Way, your pharmacists will know about problems that could occur when fill. Must be enrolled in both Medicare Part a and Part B to enroll in a Medicare..

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