BCBS Anthem Formulary: Your Complete Resource for Medication Information

The BCBS Anthem formulary is a comprehensive guide to medication information, designed to help you make informed decisions about your health. It's a valuable resource for navigating the complex world of prescription medications.

The formulary is regularly updated to reflect the latest medical research and treatment guidelines. This ensures that you have access to the most effective and up-to-date treatments for your specific health needs.

The BCBS Anthem formulary covers a wide range of medications, including those for chronic conditions like diabetes, hypertension, and asthma. By understanding which medications are covered and which are not, you can plan your treatment and make informed decisions about your care.

Understanding the BCBS Anthem formulary can also help you save money on your prescription medications. By choosing medications that are covered by your plan, you can reduce your out-of-pocket costs and make your healthcare dollars go further.

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Finding Medications is a straightforward process with BCBS Anthem. The formulary, also known as the drug list, is a comprehensive list of all brand-name and generic drugs available in your plan. All drugs on the formulary are covered, but some may require preapproval before the prescription can be filled.

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You can find the formulary by visiting the BCBS Anthem website or reviewing your member's benefits booklet. The drugs are listed in alphabetical order based on the name of their drug class, also called therapeutic class. This makes it easy to search for a specific medication by typing its name into the PDF drug list.

To search for a drug on the list, simply type its name into the PDF drug list. If you're having trouble finding a specific medication, you can always reach out to BCBS Anthem for assistance.

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Your BCBS Anthem formulary is a list of prescription medicines your plan covers. It includes hundreds of brand-name and generic drugs approved by the U.S. Food & Drug Administration (FDA).

To find your plan's applicable drug lists, check the Benefit/Program Drug Lists section. This is where you'll find information about One or more Benefit/Program Drug Lists that may apply to your plan.

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PreventiveRx Plus is a benefit that includes two drug lists: Legacy PreventiveRx Plus Drug List and PreventiveRx Enhanced Drug List. These lists are available in English and Spanish.

If you're looking for the Prescription Drugs Your Plan Covers, you can search or download Anthem Blue Cross and Blue Shield drug lists by choosing your state. This will give you access to up-to-date information about your pharmacy coverage.

The drug lists are organized alphabetically by drug class, making it easy to search for specific medications. You can also search the PDF drug list by typing in the name of the drug you're looking for.

Here are some key types of drug lists:

Note that while most medications on the Preferred Drug List (PDL) are covered without prior authorization, a few agents will require you to contact the Pharmacy department for authorization.

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Prior Authorizations are a common process in the healthcare system, and it's essential to understand how they work, especially when it comes to getting the medications you need.

Some medicines require a preapproval from Anthem before your doctor can prescribe them, which helps ensure you're taking medications safely and correctly.

The preapproval process is in place to prevent misuse or abuse of certain medications, as well as to ensure that other treatments have been tried first.

Your provider will need to contact Anthem to request preapproval, and Anthem will review the request and give a decision within 24 hours.

If you need your medicine right away, you may be able to receive a 72-hour supply while you wait.

Here are some reasons why preapproval may be needed:

You can find Prior Authorization forms for pharmacy services on the Forms page, including those for medical injectables, which also apply to Medicaid members.

You have over 67,000 pharmacies to choose from nationwide, which can be a lot to navigate.

Your plan's network includes two levels of coverage: Level 1 and Level 2.

Level 1 has nearly 26,000 preferred pharmacies, including big chains like CVS, Target, and Walmart, which can help you save on medication costs.

You can also fill prescriptions at non-preferred Level 2 pharmacies, but you may pay more.

There are over 40,000 of these pharmacies in the plan's network.

If you take medication regularly for conditions like asthma, diabetes, or high cholesterol, you'll need to set up 90-day supplies at a pharmacy in the Rx Maintenance 90 network, including CVS retail or home delivery.

You can save time and money with the home delivery service, which delivers up to 90-day supplies with free standard shipping.

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As a member of BCBS Anthem, you have access to a range of resources to help you manage your pharmacy plan. You can search for specific medication information or find an Rx Network online.

If you're having trouble understanding the plan or need help with a specific issue, don't worry! You can get an interpreter or have documents read to you in your language, free of charge. Just call 1-888-254-2721 or look on your ID card for the phone number.

If you're still having trouble, you can also contact the CA Dept. of Insurance at 1-800-927-4357. They're here to help and can provide assistance in multiple languages.

You can get documents sent to you in your language, which can be really helpful if you're not fluent in English. This way, you can stay on top of your plan and make informed decisions about your healthcare.

Lists of Excluded Medications can be a bit confusing, but essentially, they're a list of specialty medications that are not covered under the pharmacy benefit, unless certain exceptions apply. This means that if a medication is on this list, it won't be included in your pharmacy coverage.

For example, Specialty Drug Benefit Exclusion Lists exist, which are specific to certain medications that are covered by a member's plan but not under the pharmacy benefit. These lists can vary, and it's essential to check your plan's specifics.

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