Chiamate il Servizio per i membri al numero riportato sulla vostra scheda identificativachiamata1-800-472-2689(TTY: 711 ). Effective with dates of service on and after October 1, 2020, and in accordance with the IngenioRx Pharmacy and Therapeutics (P&T) process, Anthem Blue Cross (Anthem) will update its drug lists that support commercial health plans. Blue MedicareRx (PDP) Value Plus (PDF) and We make receiving prescriptions as convenient as possible. , 1-800-472-2689(: 711 ). New! The preapproval process helps us make sure that youre taking medications safely and correctly. If a change affects a drug you take, we will notify you at least 60 days in advance, TTY users should call 711. If you like the convenience of having your prescription drugs delivered, you may utilize the CVS Caremark Mail-order pharmacy. However, Q1Medicare is not intended as a substitute for your lawyer, doctor, healthcare provider, financial advisor, or pharmacist. The changes apply for only new prescriptions; members with existing prescriptions for these medications will not be impacted. Typing the name (at least first three letters) of the drug in the search box. Drugs on the formulary are organized by tiers. You may also submit your request online through Cover My Meds, Surescripts, or CenterX ePA portals. MedImpact is the pharmacy benefits manager. In Maine: Anthem Health Plans of Maine, Inc. Change State. If you have the PreventiveRx Drug List (Preferred), please refer to the PreventiveRx Plus Drug List (National) above. All the drugs we cover are carefully selected to provide the greatest value while meeting the needs of our members. Medi-Cal pharmacy website for more information. Massachusetts, Rhode Island, and Vermont. Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont Generally, Medicaid members are in the following categories: Under age 21 A pregnant woman A family with children Childless adult aged 19-64 who meets federal income requirements See if you're eligible. For more recent information or other questions, please contact Customer Care at 1-844-345-4577, 24 hours a day, 7 days a week. The benefit information provided is a brief summary, not a complete description of benefits. However, the drug list is not intended to be a substitute for a doctor's clinical knowledge and judgment. If you have the Essential formulary/drug list, this PreventiveRx drug list may apply to you: If you have the National formulary/drug list, one of these PreventiveRx drug lists may apply to you: If you have the National Direct formulary/drug list, one of these PreventiveRx drug lists may apply to you: Anthem has aligned the National and Preferred Drug Lists. Gives your doctor access to key information about you like your medical history, applicable formulary, and potential drug interactions. 2022 Part D Formulary (List of Covered Drugs) Register on our website to choose to receive plan communications by email or online. are the legal entities which have contracted as a joint enterprise with the Centers The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change. The joint enterprise is a Medicare-approved Part D Sponsor. When you fill your prescription Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. ID 1-800-472-2689TTY 711 ). A doctor can also call in the prescription for you. Out of the 63,000+ Providers may need to get approval from MedImpact for certain drugs. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). To request a printed copy of our pharmacy directory call us, 24 hours a day, 7 days a week. 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. ID 1-800-472-2689TTY: 711 . If you need your medicine right away, you may be able to get a 72-hour supply while you wait. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Contact the Medicare plan for more information. For more information, contact the plan. Prescription vitamins and minerals (except for prenatal vitamins and fluoride preparations). 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. ET, seven days a week. SM, TM Registered and Service Marks and Trademarks are property of their respective owners. Providers who do not contract with the plan are not required to see you except in an emergency. Drugs for treatment of sexual or erectile dysfunction (ED). Tawagan ang Mga Serbisyo sa Miyembro sa numerong nasa iyong ID Card tumawag1-800-472-2689(TTY: 711 ). Please see, Select your search style and criteria below or use this example to get started. See individual insulin cost-sharing below. OTC drugs aren't shown on the list. ATTENTION: If you speak a language other than English, language assistance services are available to you free of charge. TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult. View a summary of changes here . An independent group of practicing doctors, pharmacists and other health-care professionals meet often to look at new and existing drugs. View can also view our Rx Maintenance 90 pharmacies, where you can obtain up to a 90-day supply of your medicine, by going to the Rx Networks page. IngenioRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Anthem. Your doctor can get the process started by calling the Pharmacy Member Services number on It features low $1 copays for tier 1 prescription drugs. By law, certain types of drugs or categories of drugs are not covered under Medicare Part D. The formulary was last updated on 03/01/2023 andmay change during the year. In some cases, retail drugs and supplies are covered under your Part B of Original Medicare medical benefit (e.g. Blue MedicareRx (PDP) is a Prescription Drug Plan with a Medicare contract. A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. The joint enterprise is a Medicare-approved Part D Sponsor. Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., LU . : , . 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. Your doctor can prescribe most of these medicines to you without getting preapproval or an OK from us. Medallion Medicaid/FAMIS: 1-800-901-0020 or union group and separately issued by one of the following plans: Anthem Blue 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. or union group and separately issued by one of the following plans: Anthem Blue Customer Support You can call a licensed agent directly at 1-866-831-1126 . Some medicines need a preapproval or an OK from the Anthem HealthKeepers Plus plan before your provider can prescribe them. In certain situations, you can. S2893_2244 If you have a complex or chronic health condition that requires special medicine, you can get the medicine you need. Products & Programs / Pharmacy. Phone: 800-977-2273 or 711 for TTY. 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. You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWI), whichunderwrites or administersthe PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare Health Services Insurance Corporation (Compcare) underwritesor administers the HMO policies and Wisconsin Collaborative Insurance Company (WCIC) underwrites or administers Well Priority HMO or POS policies. Check with your employer or contact the Pharmacy Member Services number on your ID card if you need assistance. Clicking on the therapeutic class of the drug. Enrollment in Blue MedicareRx (PDP) depends on contract renewal. Drugs for treatment of anorexia, weight loss or weight gain. 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). To help 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. Your benefits include a wide range of prescriptions and over-the-counter (OTC) medicines. There is a generic or pharmacy alternative drug available. Use the Drug Pricing Tool to price the medications you are currently taking and see which Blue MedicareRx plan is best for you. All drugs on the formulary are covered, but many require preapproval before the prescription can be filled. 500 MG VIAL [Zithromax], Everyone in your household can use the same card, including your pets. 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. If you use another pharmacy, you should tell the pharmacist about all medicines you are taking. To request a printed copy of our pharmacy directory call us, 24 hours a day, 7 days a week. We offer an outcomes-based formulary. To ensure a smooth member transition and minimize costs, providers should review these changes and consider prescribing medications on formulary, if appropriate. How you know. : , , : .. We look forward to working with you to provide quality services to our members. Availity, LLC is an independent company providing administrative support services on behalf of Anthem Blue Cross and Blue Shield Medicaid. 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. If you dont 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.Youll be asked to supply a reason why it should be covered, such as an allergic reaction to a drug, etc. or add a special coverage requirement. The formulary is a list of our covered prescription drugs, including generic, brand name and specialty drugs. drug on our Drug List, but immediately move it to a different cost-sharing Use the formulary to search by drug name or disease category: For Medi-Cal drug coverage, please use the Medi-Cal Contract Drug List. Those who disenroll 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. , call: 1-800-MEDICARE ( 1-800-633-4227 ), 24 hours a day, 7 a... A list of covered drugs ) Register on our website to choose receive. The medicine you need at new and existing drugs official website of 63,000+! Of covered drugs ) Register on our website to choose to receive plan communications by or... ( PFFS ) is not a Medicare Advantage plan drug interactions including generic, name!.. We look forward to working with you to provide quality services to members! 1-877-486-2048, 24 hours a day, 7 days a week Medicare medical benefit ( e.g support on! 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