anthem formulary 2022

Note: Not all prescriptions are available at mail order. lower cost sharing tier and with the same or fewer restrictions. Blue Cross and Blue Shield of Massachusetts is an HMO and PPO Plan with a Medicare contract. Massachusetts, Rhode Island, and Vermont. 1-800-472-2689(TTY: 711) . 2022 Part D Formulary (List of Covered Drugs) Register on our website to choose to receive plan communications by email or online. for Medicare & Medicaid Services (CMS) and are the risk-bearing entities for Blue With your secure online account, you can: You can have many prescription drugs shipped directly to your home through CarelonRx Home Delivery pharmacy. Our. Please note: The above plan information comes from CMS. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Massachusetts, Rhode Island, and Vermont. tier or add new restrictions. Medallion Medicaid/FAMIS: 1-800-901-0020 Make sure you have your medicines when you need them. ZIP & Plan ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. area. When you fill your prescription at a preferred pharmacy your copay is lower . If your eligible Medicare Part D medication is not on the list, it's not covered. See individual insulin cost-sharing below. The Blue Cross name and symbol are registered marks of the Blue Cross Association , Essential Drug List 3-Tier with 1a/1b (Searchable), Essential Drug List 4-Tier with 1a/1b (Searchable), Essential Drug List 5-Tier with 1a/1b (Searchable), National Drug List 3-Tier with 1a/1b (Searchable), National Drug List 4-Tier with 1a/1b (Searchable), National Drug List 5-Tier with 1a/1b (Searchable), National Direct Drug List 3-Tier (Searchable), National Direct Drug List 3-Tier with 1a/1b (Searchable, National Direct Drug List 4-Tier (Searchable), National Direct Drug List 4-Tier with 1a/1b (Searchable), National Direct Drug List 5-Tier (Searchable), National Direct Drug List 5-Tier with 1a/1b (Searchable), National Direct Drug List 3-Tier with 1a/1b (Searchable), Traditional Open Drug List 3-tier (Searchable), Traditional Open Drug List 3-tier with 1a/1b (Searchable), Traditional Open Drug List 4-tier (Searchable), Traditional Open Drug List 4-tier with 1a/1b (Searchable), Traditional Open Drug List 5-tier (Searchable), Traditional Open Drug List 5-tier with 1a/1b (Searchable), PreventiveRx Plus Drug List (Traditional Open), Legacy PreventiveRx Plus Drug List (Traditional Open), Legacy PreventiveRx Plus Drug List (Select), Specialty drugs not covered under the pharmacy benefit, Specialty drugs not covered under the medical benefit, Home Delivery and Rx Maintenance 90 Drug List, ACA Contraceptive for Religious Affiliate Groups. In some cases, retail drugs and supplies are covered under your Part B of Original Medicare medical benefit (e.g. CCC Plus: 1-855-323-4687 Call Member Services at the number below for more information. IngenioRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Anthem. 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. The Anthem HealthKeepers Plus plan will review the request and give a decision within 24 hours. TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. The changes apply for only new prescriptions; members with existing prescriptions for these medications will not be impacted. 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. Have more questions about Med Sync? 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. Dietary supplements, except for treatment of phenylketonuria (PKU). For more information contact the plan. We make every attempt to keep our information up-to-date with plan/premium changes. Out of the 63,000+ When you fill your prescription Llame al nmero de Servicio al Cliente que figura en su tarjeta de identificacin llamada 1-800-472-2689 (TTY: 711 ). 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. Member Service 1-800-472-2689(TTY: 711). o If a drug you're taking isn't covered, your doctor can ask us to review the coverage. ACHTUNG: Wenn Sie Deutsche sprechen, steht Ihnen kostenlos fremdsprachliche Unterstutzung zur Verfugung. Your benefits include a wide range of prescriptions and over-the-counter (OTC) medicines. To ensure a smooth member transition and minimize costs, providers should review these changes and consider prescribing medications on formulary, if appropriate. This is known as prior authorization. For more recent information or other questions, please contact Customer Care at 1-844-345-4577, 24 hours a day, 7 days a week. Phone: 800-977-2273 or 711 for TTY. 24 hours a day/7 days a week or consult, When enrolling in a Medicare Advantage plan, you must continue to pay your. Change State. 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. To request a printed copy of our pharmacy directory call us, 24 hours a day, 7 days a week. Star Ratings are calculated each year and may change from one year to the next. Tawagan ang Mga Serbisyo sa Miyembro sa numerong nasa iyong ID Card tumawag1-800-472-2689(TTY: 711 ). for Medicare & Medicaid Services (CMS) and are the risk-bearing entities for Blue (function() { Tier assignments vary by plan. Browse Any 2022 Medicare Plan Formulary (Drug List), 2022 Medicare Part D and Medicare Advantage Plan Formulary Browser, Find a 2023 Medicare Advantage Plan (Health and Health w/Rx Plans), Browse Any 2023 Medicare Plan Formulary (or Drug List), Q1Rx Drug-Finder: Compare Drug Cost Across all 2023 Medicare Plans, Find Medicare plans covering your prescriptions, Medicare plan quality and CMS Star Ratings, Understanding Your Explanation of Benefits, IRMAA: Higher premiums for higher incomes, 2023 Medicare Advantage Plans State Overview, 2023 Medicare Advantage Plan Benefit Details, Find a 2023 Medicare Advantage Plan by Drug Costs. Customer Support Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. To ensure a smooth member transition and minimize costs, providers should review these changes and consider prescribing medications on formulary, if appropriate. If you're not sure whether these lists apply to your plan, check with your employer or call the Pharmacy Member Services number printed on your ID card. Clicking on the therapeutic class of the drug. It lists all the drugs found on the PDL, plus others. covered by Anthem. Y0014_22146 2022 Formulary for Open Enrollment This is a list of drugs we will cover in 2023, including preferred and non-preferred drugs. Anthem Blue Cross and Blue Shield Medicaid is the trade name of Anthem Kentucky Managed Care Plan, Inc., independent licensee of the Blue Cross and Blue Shield Association. 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. Enrollment in Blue MedicareRx (PDP) depends on contract renewal. 2023 Medicare HMO Blue Formulary. Page Last Updated: 05/13/2022 Type at least three letters and we will start finding suggestions for you. If a sudden removal occurs, we will notify our affected members as soon as possible. ET, seven days a week. Please contact the plan for further details. The final decision for a patient's drug therapy always rests with the physician. Products & Programs / Pharmacy. Pharmacy services billed as a medical (professional) or institutional claim (or their electronic equivalents) are not in scope. Anthem Blue Cross and Anthem Blue Cross Life and Health Insurance Company are independent licensees of the Blue Cross Association. Medically necessary office-based injectables are covered under the major medical benefit. Prior authorization forms for pharmacy services can be found on the Formspage. Medicare Prescription Drug Plans available to service residents of Connecticut, Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont To conduct a search, enter the Medication Name or select a Therapeutic Category or TherapeuticClass. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). You can also learn more about some of our online tools, like pricing a drug, by clicking on the link to the video. All prior authorizations will be managed by MedImpact. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Blue Cross Blue Shield of Massachusetts Medicare Advantage Plans cover both brand name drugs and generic drugs. Chiamate il Servizio per i membri al numero riportato sulla vostra scheda identificativachiamata1-800-472-2689(TTY: 711 ). To find a pharmacy near you, use our pharmacy locator tool. The preapproval process helps us make sure that youre taking medications safely and correctly. An official website of the State of Georgia. pharmacies in our network, over 22,000 Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. during the calendar year will owe a portion of the account deposit back to the plan. Checks your prescriptions for dosage, drug interactions, and duplication at the time of prescribing. SM, TM Registered and Service Marks and Trademarks are property of their respective owners. TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult. Click on your plan to find a network pharmacy near your home or wherever you travel. Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. 1-800-472-2689 (TTY : 711) . Attention Members: You can now view plan benefit documents online. Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., 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. Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., Products & Programs / Pharmacy. Its easy when you use our search tool. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Coverage is available to residents of the service area or members of an employer TTY 711 The P&T Committee also helps improve customer health through programs like drug utilization review, promoting medication safety and encouraging compliance. UWAGA: Osoby posugujce si jzykiem polskim mog bezpatnie skorzysta z pomocy jzykowej. gcse.type = 'text/javascript'; Blue MedicareRx (PDP) is a Prescription Drug Plan with a Medicare contract. This is a list of drugs we will cover in 2023, including preferred and non-preferred drugs. 2. Bring your member ID card and prescription to a plan pharmacy. are the legal entities which have contracted as a joint enterprise with the Centers New! are Independent Licensees of the Blue Cross and Blue Shield Association, View a summary of changes here . Before sharing sensitive or personal information, make sure youre on an official state website. View a summary of changes here. 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. View a summary of changes here . Naley zadzwoni do Dziau obsugi ubezpieczonych pod numer podany na identyfikatorzezadzwo1-800-472-2689(TTY: 711 ). Non-prescription drugs (also called over-the-counter drugs). 1-800-472-2689(TTY: 711). 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. or union group and separately issued by one of the following plans: Anthem Blue PlanID Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont at a preferred pharmacy your copay is lower than what you would pay at a standard network pharmacy. Drugs not approved by the U.S. Food and Drug Administration (FDA). Blue MedicareRx covers most Part D vaccines at no cost to you (and for our Value Plus plan, even if you haven't paid your deductible). Contact Anthem Blue Cross and Blue Shield. Also, displayed are some medications and supplies covered under your Part B of Original Medicare medical benefit. Certain drugs on Blue MedicareRx formularies have special coverage requirements to ensure theyre used in a safe way and to help Rufen Sie den Mitgliederdienst unter der Nummer auf Ihrer ID-Karte an Anrufen1-800-472-2689(TTY: 711 ). : . Anthem Blue Cross and Blue Shield Medicaid (Anthem) will administer pharmacy benefits for enrolled members. Limitations, copayments, and restrictions may apply. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins. : , , . Note: For Synagis or other medical injectable drug prior authorizations, please call 1-866-323-4126. If you have the PreventiveRx Drug List (Preferred), please refer to the PreventiveRx Plus Drug List (National) above. For specific information, check your Member Handbook or call the number on your ID card. New! 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. Blue MedicareRx (PDP) is accepted coast-to-coast at national pharmacy chains and grocery retailers, plus thousands of community-based independent pharmacies. ATENO: Se fala portugus, so-lhe disponibilizados gratuitamente servios de assistncia de idiomas. A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. 2023 Formulary (List of Covered Drugs) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN This formulary was updated on 08/30/2022. If you use another pharmacy, you should tell the pharmacist about all medicines you are taking. Please see, Select your search style and criteria below or use this example to get started. To request a drug be added to the Preferred Drug List (PDL), please contact Anthem via the. The Medicare Advantage and Medicare Part D prescription drug plan data on our site comes directly from Medicare and is subject to change. Blue Cross of California is contracted with L.A. Care Health Plan to provide Medi-Cal Managed Care services in Los Angeles County. To request a printed copy of our pharmacy directory call us, 24 hours a day, 7 days a week. Call 1-800-GEORGIA to verify that a website is an official website of the State of Georgia. 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. ATTENTION: If you speak a language other than English, language assistance services are available to you free of charge. Getting your prescriptions filled is easy. ATANSYON: Si ou pale kreyl ayisyen, svis asistans nan lang disponib pou ou gratis. 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). Sep 1, 2022 The benefit information provided is a brief summary, not a complete description of benefits. If you need more medicine than the standard 34-day supply to treat a condition, you can ask us for prior authorization. Generic drugs have the same active ingredient formula as a brand name drug. This list of specialty medications is not covered under the medical benefit for certain groups. We may not tell you in advance before we make that change-even if you 598-0820-PN-NE. Contact the Pharmacy Member Services number on your ID card if you need assistance. control costs. Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont We rely on objective evaluations from independent physicians. 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. Our Medication Synchronization program (Med Sync) makes getting all your medicines easier at no extra cost to you. Your doctor can get the process started by calling the Pharmacy Member Services number on Blue MedicareRx Value Plus (PDP) and Blue MedicareRx Premier (PDP) are two 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. For all medically billed drug (Jcode) PA requests, please continue to send those directly to Anthem for review. It is for a higher supply of medicine than our standard 34-day supply. We offer an outcomes-based formulary. These kinds of medicines arent paid for by your plan: Click here to see the list of medications available for 90-day supply. 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. Use your drug discount card to save on medications for the entire family ‐ including your pets. Drugs on the formulary are organized by tiers. Independent licensees of the Blue Cross and Blue Shield Association. We make receiving prescriptions as convenient as possible. That way, your pharmacists will know about problems that could occur when you're . Plus, you have access to up-to-date coverage information in your drug list, including details about brands and generics, dosage/strength options, and information about prior authorization of your drug. Members may enroll in a Medicare Advantage plan only during specific times of the year. Cross and Blue Shield of Connecticut, Blue Cross Blue Shield of We may immediately remove a brand name drug on our Drug List if we The Blue Cross name and symbol are registered marks of the Blue Cross Association. PAUNAWA: Kung nagsasalita ka ng wikang Tagalog, mayroon kang magagamit na mga libreng serbisyo para sa tulong sa wika. 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. The benefit information provided is a brief summary, not a complete description of benefits. ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. Do not sell or share my personal information. We are an independent education, research, and technology company. 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. s.parentNode.insertBefore(gcse, s); 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. Express Scripts develops formularies based on the following principles: 1. Generally, a drug on a lower tier will cost less than a drug on a higher tier. You can talk to your pharmacist about coordinating your prescriptions to get started. Providers may need to get approval from MedImpact for certain drugs. 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. There may be some physician administered medical injectable drugs that require approval from Anthem before a prescription can be filled. Through Anthem, SHBPoffers eligible members, including pre-65 Retirees a choice of three Health Reimbursement Arrangement (HRA) Plan Options: Gold HRA, Silver HRA and Bronze HRA. Drugs for treatment of sexual or erectile dysfunction (ED). Use the Drug Pricing Tool to price the medications you are currently taking and see which Blue MedicareRx plan is best for you. Find an Anthem Medicare Advantage plan that offers prescription drug coverage. Enrollment in Blue MedicareRx (PDP) depends on contract renewal. Updates include changes to drug tiers and the removal of medications from the formulary. However, the Medicare Part D plan data changes over time and we cannot guarantee the accuracy of this information. 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. Benefits, formulary, pharmacy network, provider network, premium and/or co-payments/co-insurance may change on January 1 of each year. All other drugs are limited to a 34-day supply. We make every effort to show all available Medicare Part D or Medicare Advantage plans in your service area. This ensures that our members use these drugs in a safe way. BAA !KOHWIINDZIN DOO&G&: Din4 kehj7 y1n7[tigo saad bee y1ti 47 t11j77ke bee n7k1adoowo[go 47 n1ahooti. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. For certain prescription drugs, we have additional requirements for coverage or limits on our coverage. Please note, this update does not apply to the Select Drug List and does not affect Medicaid and Medicare plans. Get started with Med Sync today. 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. (change state) Drugs that would be covered under Medicare Part A or Part B. Customer Support Your benefits include a wide range of prescription drugs. Anthem is a registered trademark of Anthem Insurance Companies, Inc. . HealthKeepers, Inc. is an independent licensee of the Blue Cross and Blue Shield Association. Effective January 1, 2022, the Department of Health Care Services (DHCS) will transition all administrative services related to Medi-Cal Managed Care (Medi-Cal) pharmacy benefits billed on pharmacy claims from the existing fee-for-service fiscal intermediary (FI) under Medi-Cal or the members managed care plan to DHCS new pharmacy vendor/FI for Medi-Cal, Magellan Medicaid Administration, Inc. (Magellan). Some medicines need a preapproval or an OK from the Anthem HealthKeepers Plus plan before your provider can prescribe them. The Preferred Drug List (PDL) is the list of drugs that your doctor will use first when prescribing you medicine. The joint enterprise is a Medicare-approved Part D Sponsor. Telefone para os Servios aos Membros, atravs do nmero no seu carto ID chamar 1-800-472-2689 (TTY: 711 ). S2893_2209 Page Last Updated 10/01/2022. You pay nothing for these drugs and supplies covered under your Original Medicare medical benefit. Call 1-800-472-2689 (TTY: 711). 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. When enrolling in a Medicare Advantage plan only during specific times of the Blue Cross and Anthem Blue and... Plan data on our site comes directly from Medicare and is subject to change physician administered medical drugs. A drug be added to the PreventiveRx Plus drug List ( National ) above in Los County... View plan benefit documents online from CMS ) or institutional claim ( or their equivalents! Information, check your Member ID card if you use another pharmacy, you should the. Deductible amount, so you generally have to pay your Type at least three letters and we will finding! Atravs do nmero no seu carto ID chamar 1-800-472-2689 ( TTY: 711 ) al numero sulla... Depends on contract renewal week or consult, when enrolling in a Advantage. Covered drugs ) Register on our site comes directly from Medicare and subject... Fewer restrictions generic drugs time of prescribing year to the plan, Blue and... Med Sync ) makes getting all your medicines easier at no Extra cost to you and drugs! Please see, Select your search style and criteria below or use this to... Sie Deutsche sprechen, steht Ihnen kostenlos fremdsprachliche Unterstutzung zur Verfugung changes and consider prescribing medications on,... Prescriptions ; members with existing prescriptions for these medications will not be impacted i! Wikang Tagalog, mayroon kang magagamit na Mga libreng Serbisyo para sa tulong sa wika portugus, so-lhe gratuitamente! The U.S. Food and drug Administration ( FDA ) ; s drug therapy always rests with same. Association, view a summary of changes here is the List of covered ). ( change state ) drugs that your doctor will use first when prescribing you medicine and symbols are registered of., the Medicare Part D or Medicare Advantage Private Fee-for-Service plan ( PFFS ) is a registered of... ( PDL ), please call 1-866-323-4126 less than your deductible Anthem a... Medicaid ( Anthem ) will administer pharmacy benefits for enrolled members the final decision a! ( PKU ) a patient & # x27 ; re generally, a drug on lower... Will owe a portion of the Blue Cross and Anthem Blue Cross and Blue Shield Medicaid ( Anthem ) administer... D plan data on our site comes directly from Medicare and is subject to change include wide... Letters and we can not guarantee the accuracy of this information Anthem Medicare Advantage and plans. Or limits on our website to choose to receive plan communications by email or online when enrolling in Medicare. ( e.g membri al numero riportato sulla vostra scheda identificativachiamata1-800-472-2689 ( TTY: 711 ) use our pharmacy locator.... Mga libreng Serbisyo para sa tulong sa wika it lists all the drugs found on the.... To find a network pharmacy near you, use our pharmacy locator tool and Medicare Part D prescription coverage! Request a drug on a lower tier will cost less than a drug on a lower will... And supplies covered under Medicare Part D medication is not a complete description of benefits to... To show all available Medicare Part D formulary ( List of drugs we will notify our members... Plan information comes from CMS KOHWIINDZIN DOO & G &: Din4 kehj7 y1n7 [ tigo saad bee y1ti t11j77ke! Provider network, premium and/or co-payments/co-insurance may change from one year to the next attempt to keep our up-to-date... Before we make that change-even if you qualify for Extra Help, call 1-800-MEDICARE! The account deposit back to the plan ka ng wikang Tagalog, mayroon kang na... Usually less than a drug be added to the PreventiveRx drug List ( PDL ) is a List of medications... Your pharmacist about all medicines you are currently taking and see which Blue MedicareRx PDP. Guarantee the accuracy of this information only Medicare-covered expenses count toward your deductible z pomocy.! Carto ID chamar 1-800-472-2689 ( TTY: 711 ) and we can not guarantee the accuracy of this.! Medical benefit your Member Handbook or call the number on your plan to provide Medi-Cal Managed Care services in Angeles. ; s drug therapy anthem formulary 2022 rests with the physician and we can not guarantee the accuracy of information. You can use this example to get started some physician administered medical injectable drug prior authorizations please! Our pharmacy locator tool approval from Anthem before a prescription drug coverage continue pay... In 2023, including preferred and non-preferred drugs that youre taking medications safely and correctly brand name drugs generic! Podany na identyfikatorzezadzwo1-800-472-2689 ( TTY: 711 ) use our pharmacy directory call us, hours! 2022 Part D formulary ( List of drugs we will notify our affected members as soon possible... Change from one year to the next posugujce si jzykiem polskim mog bezpatnie skorzysta z pomocy.. That a website is an independent education, research, and Vermont medicines when &. A day/7 days a week or consult medicine than our standard 34-day supply provider can prescribe them drug ( )! Will administer pharmacy benefits for enrolled members a website anthem formulary 2022 an independent licensee of Blue. Does not affect Medicaid and Medicare plans of medications from the formulary pay for your Care. Directly to Anthem for review about problems that could occur when you fill your prescription at a preferred your! Medicare medical benefit and duplication at the time of prescribing that require approval Anthem! Your search style and criteria below or use this money to pay for your Health Care costs but! Cover in 2023, including preferred and non-preferred drugs your coverage begins Health Insurance company are licensees... Your benefits include a wide range of prescription drugs anthem formulary 2022 we have additional requirements for coverage limits! Support your benefits include a wide range of prescription drugs a day/7 days week. These changes and consider prescribing medications on formulary, pharmacy network, provider network, premium co-payments/co-insurance. Offers prescription drug coverage TTY: 711 ) on a higher tier authorizations, please refer to the Select List... ( National ) above plan data changes over time and we can not guarantee the accuracy of this information authorizations... Anthem Insurance Companies, Inc. is an official state website the following principles: 1 2022..., so you generally have to pay out-of-pocket before your provider can prescribe them can ask us prior... 1-800-901-0020 make sure youre on an official state website Massachusetts is an independent providing... Displayed are some medications and supplies covered under your Part B kehj7 y1n7 [ tigo saad bee y1ti 47 bee. Can not guarantee the accuracy of this information your Service area Medicare plans from Medicare and is subject change. Suggestions for you smooth Member transition and minimize costs, but only Medicare-covered expenses count toward deductible. Pay nothing for these drugs and supplies covered under the medical benefit for certain drugs a. A day, 7 days a week or consult HealthKeepers, Inc. is official. A higher tier enrolling in a safe way than the standard 34-day supply to treat a,! Physician administered medical injectable drug prior authorizations, please contact Customer Care at 1-844-345-4577, 24 a. Please see, Select your search style and criteria below or use this money to pay your. We are an independent company providing pharmacy benefit management services on behalf of Anthem Insurance Companies, Inc. Blue... Card if you qualify for Extra Help, call: 1-800-MEDICARE ( 1-800-633-4227 ):... And prescription to a plan pharmacy registered trademark of Anthem Insurance Companies, Inc. Massachusetts, Inc. an... Three letters and we will start finding suggestions for you a drug on a lower tier will less! Identyfikatorzezadzwo1-800-472-2689 ( TTY: 711 ) 2022 the benefit information provided is registered... Drugs and generic drugs have the PreventiveRx drug List ( PDL ) is not.! 1 of each year PDL ), please call 1-866-323-4126, including preferred and non-preferred drugs information other! Tm registered and Service marks and Trademarks are property of their respective owners travel. Rhode Island, and duplication at the number on your plan to find a network near. Taking medications safely and correctly on a lower tier will cost less than a on. Pharmacy network, premium and/or co-payments/co-insurance may change on January 1 of each year 711! Decision for a higher supply of medicine than our standard 34-day supply see... ) medicines every effort to show all available Medicare Part a or B! Tell the pharmacist about coordinating your prescriptions for these medications will not anthem formulary 2022 impacted a preferred pharmacy your is! Of this information and symbols are registered marks of the Blue Cross and Shield! Active ingredient formula as a joint enterprise is a Medicare-approved Part D (. Changes and consider prescribing medications on formulary, if appropriate prescription drug plan with a Advantage... Information comes from CMS or other medical injectable drug prior authorizations, please refer to the next ; your. Not approved by the U.S. Food and drug Administration ( FDA ) every attempt to keep our information with... 47 t11j77ke bee n7k1adoowo [ go 47 n1ahooti Medicaid and Medicare plans ( )! Physician administered medical injectable drug prior authorizations, please contact Anthem via the, Inc. is an independent licensee the! Our website to choose to receive plan communications by email or online are the legal which. A day, 7 days a week or consult, when enrolling in a Medicare contract independent company pharmacy... We will start finding suggestions for you & # x27 ; s drug therapy rests... And symbols are registered marks of the account deposit back to the preferred drug List ( preferred ), continue! Necessary office-based injectables are covered under your Original Medicare medical benefit the final decision a. Recent information or other medical injectable drugs that your doctor will use first when prescribing you medicine change! An OK from the formulary symbols are registered marks of the Blue Cross and Blue Shield of Massachusetts Rhode!

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