The joint enterprise is a Medicare-approved Part D Sponsor. Medicare evaluates plans based on a 5-Star rating system. 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. 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). 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. Medi-Cal pharmacy website for more information. Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont Attention Members: You can now view plan benefit documents online. 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. Certain drugs on Blue MedicareRx formularies have special coverage requirements to ensure theyre used in a safe way and to help D77 bee an7tah7g7 ninaaltsoos bined44 n0omba bik17g7ij8 b44sh bee hod77lnih call1-800-472-2689(TTY: 711). Hours: Monday to Friday from 8 a.m. to 7 p.m. Eastern time. S2893_2244 Call 1-800-472-2689 (TTY: 711). TTY users should call, 1-800-325-0778; or your state Medicaid Office. 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. Massachusetts, Blue Cross & Blue Shield of Rhode Island, and Blue Cross and S2893_2209 Page Last Updated 10/15/2022. 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. Pharmacy services billed as a medical (professional) or institutional claim (or their electronic equivalents) are not in scope. Use of the Anthem Web sites constitutes your agreement with our Terms of Use. We offer an outcomes-based formulary. The Anthem HealthKeepers Plus plan will review the request and give a decision within 24 hours. Type at least three letters and we will start finding suggestions for you. To submit electronic prior authorization (ePA) requests online, use Availity. 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. Phone: 800-977-2273 or 711 for TTY. : -, . gcse.src = (document.location.protocol == 'https:' ? To get Nevada Medicaid benefits through Anthem, you must have limited income and live in one of our service areas. 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. Contact the plan provider for additional information. In Maine: Anthem Health Plans of Maine, Inc. Get started with Med Sync today. Enrollment in Blue MedicareRx (PDP) depends on contract renewal. 1-800-472-2689(TTY: 711). 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. 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. adding the new generic drug, we may decide to keep the brand name All drugs on the formulary are covered, but many require preapproval before the prescription can be filled. Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Note: For Synagis or other medical injectable drug prior authorizations, please call 1-866-323-4126. To conduct a search, enter the Medication Name or select a Therapeutic Category or TherapeuticClass. Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont Using the A to Z list to search by the first letter of your drug. New! The PDL is updated frequently. Attention Members: You can now view plan benefit documents online. Availity. Blue MedicareRx (PDP) is accepted coast-to-coast at national pharmacy chains and grocery retailers, plus thousands of community-based independent pharmacies. October 1 through March 31, 8:00 a.m. to 8:00 p.m. Out of the 63,000+ pharmacies in our network, over 22,000 are preferred retail cost-sharing network pharmacies. : . See individual insulin cost-sharing below. Limitations, copayments, and restrictions may apply. Prescription vitamins and minerals (except for prenatal vitamins and fluoride preparations). You can compare Anthem Medicare Advantage plans available where you live to find a plan that covers the prescription drugs you need. Please see PDPFinder.com or MAFinder.com for current plans. 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. Drugs on the formulary are organized by tiers. They will work with the pharmacy and the Anthem HealthKeepers Plus plan to review your case and replace your medicines as needed. Drugs that would be covered under Medicare Part A or Part B. You may ask us to cover a Medicare Part D medication not listed on our formulary by requesting a formulary exception to waive coverage restrictions or limits on your medication. If you need your medicine right away, you may be able to get a 72-hour supply while you wait. Blue Shield of Vermont. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). Use of the Anthem websites constitutes your agreement with our Terms of Use. or union group and separately issued by one of the following plans: Anthem Blue Your benefits include a wide range of prescription drugs. lancets, test strips). UWAGA: Osoby posugujce si jzykiem polskim mog bezpatnie skorzysta z pomocy jzykowej. 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. Work with your pharmacist so you can stick to a medicine routine. at a preferred pharmacy your copay is lower than what you would pay at a standard network pharmacy. There are other drugs that should be tried first. This way, your pharmacist will know about problems that may happen when youre taking more than one prescription. Appelez le Service adhrents au numro indiqu sur votre carte dassur appel1-800-472-2689 (TTY : 711 ). 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. Non-prescription drugs (also called over-the-counter drugs). Please note, this update does not apply to the Select Drug List and does not affect Medicaid and Medicare plans. Blue Cross Blue Shield of Massachusetts is an Independent Licensee of the Blue Cross and Blue Shield Association. Please call 844-336-2676 or fax all retail pharmacy PA requests to 858-357-2612 beginning July 1, 2021. How to use the Anthem Blue Cross Cal MediConnect Formulary. All drugs on these lists are approved by the Food and Drug Administration (FDA). Generic drugs have the same active ingredient formula as a brand name drug. IngenioRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Anthem. The drug has a high side effect potential. Naley zadzwoni do Dziau obsugi ubezpieczonych pod numer podany na identyfikatorzezadzwo1-800-472-2689(TTY: 711 ). These requirements include: If you believe your use of a drug meets all special requirements, or that you should be exempt from a requirement, 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. We look forward to working with you to provide quality services to our members. Visit thePrior Authorization and Step Therapysection for more information. Featured In: September 2020 Anthem Blue . Visit the Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., 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). Its easy when you use our search tool. Drugs for cosmetic purposes or hair growth. })(); This is archive material for research purposes. Click on your plan to find a network pharmacy near your home or wherever you travel. IngenioRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Anthem. IngenioRx, Inc. is an independent company providing pharmacy benefit management services on behalf of Anthem. You may also submit your request online through Cover My Meds, Surescripts, or CenterX ePA portals. or add a special coverage requirement. 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. Out of the 63,000+ Be sure to show the pharmacy your Anthem member ID card. Generally, a drug on a lower tier will cost less than a drug on a higher tier. Formularies 2023 FEP Blue Focus Formulary View List 2023 Basic Option Formulary View List 2023 Standard Option Formulary View List Drug tiers SM, TM Registered and Service Marks and Trademarks are property of their respective owners. : , , . Some medicines need a preapproval or an OK from the Anthem HealthKeepers Plus plan before your provider can prescribe them. This ensures that our members use these drugs in a safe way. * 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. Please note: The above plan information comes from CMS. We make every attempt to keep our information up-to-date with plan/premium changes. Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. That way, your pharmacists will know about problems that could occur when you're . The joint enterprise is a Medicare-approved Part D Sponsor. In Indiana: Anthem Insurance Companies, Inc. ATENCIN: Si habla espaol, tiene a su disposicin servicios gratuitos de asistencia con el idioma. Blue MedicareRx (PDP) Premier (PDF). 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. Contact the Medicare plan for more information. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). MedicareRx (PDP) plans. We have two drug lists that show which drugs are in your plan. Dietary supplements, except for treatment of phenylketonuria (PKU). Compare plans What is a Medicare plan drug formulary? Providers may need to get approval from MedImpact for certain drugs. money from Medicare into the account. Rele nimewo Svis Manm nan ki sou kat Idantitifkasyon w lan (Svis pou Malantandan Rele 1-800-472-2689 TTY: 711 ). 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