To search a list of prescription drugs covered by our Medicare plans, also called a formulary, choose from the following options:
- Search or download the formulary. The formulary can be viewed online or downloaded by selecting this link: Drug Formulary. To view online, use the Search by Drug Name tool. To download a copy, select the Comprehensive Formulary PDF link located near the bottom of the page under Forms & Related Information.
- Request a printed document. Call the appropriate number below to have a copy mailed to you:
- MedicareBlue PPO: 1-866-434-2038; TTY users call: 711
- MedicareBlue Rx: 1-866-434-2037; TTY users call: 711
- Group MedicareBlue PPO: 1-888-457-3009; TTY users call : 711
- Group MedicareBlue Rx: 1-877-838-3827; TTY users call: 711
Assistance is available 8 a.m. to 8 p.m., daily, Central and Mountain Times.
About the drug formulary
Our drug formulary is a list of drugs selected for their value and effectiveness. The list is selected by MedicareBlue Rx in consultation with a team of professional health care providers. The formulary represents prescription therapies believed to be a necessary part of a quality treatment program. MedicareBlue Rx will generally cover the drugs listed in the formulary as long as the drug is medically necessary, the prescription is filled at a network pharmacy and other plan rules are followed.
How much will I pay for my MedicareBlue Rx covered drugs?
In order to receive maximum benefits from your coverage, the drugs you purchase must be included in the formulary and your prescriptions should be filled at one of the more than 64,000 contracted or "network" pharmacies nationwide.
What if my drug is not on the formulary?
Talk to your doctor if your drug isn’t on the formulary. He or she may be able to prescribe a different drug for you that is covered by the plan. If an alternative drug is not available or will not be as effective, your doctor can submit a formulary exception form to ask that the drug be covered.
Can the formulary change?
Yes, drugs may be added or removed during the year. If we remove drugs from our formulary or add restrictions to the drug, such as prior authorization, quantity limits and/or step therapy, or move a drug to a higher level in the formulary, we will notify members who take the drug at least 60 days before the change becomes effective. We may also notify members when they request a refill, at which time they would receive a 60-day supply of the drug. If the Food and Drug Administration deems a drug on our formulary to be unsafe or the drug’s manufacturer removes the drug from the market, we will immediately remove the drug from our formulary and provide notice to members who take the drug.
About supplemental drugs for Group plan members only
If you are a member of a Group MedicareBlueRx plan for employer and union groups, your Part D drugs are listed in the Group Comprehensive Formulary. You also have access to a supplemental drug benefit that helps pay for selected prescription drugs that Medicare does not cover and are not on the formulary. You may purchase drugs on the Supplemental List for a 25 percent coinsurance. Please note that the amount you spend on supplemental drugs does not count toward reaching your out-of-pocket maximum for catastrophic coverage. For this reason, we encourage you to talk with your doctor to identify alternate medications that are on the formulary. If you have questions about the Supplemental Drug list or Group Comprehensive Formulary, please call Customer Service at 1-877-838-3827.
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