Prescription Drug Benefits

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Drug Lists (Formularies)

Individual Coverage
Employer Coverage

If you have Individual Coverage From Capital BlueCross or HealthCare.gov

Drug Formulary	Formulary Updates
2020 Formulary (Value)	Value Formulary 2020 Opioid Updates Value Formulary Update January 1, 2020 Updates July 1, 2020 Updates
2020 CHIP Formulary	CHIP Formulary 2020 Opioid Updates CHIP Formulary Update January 1, 2020 Updates July 1, 2020 Updates

Drug Formulary

Formulary Requirements/ Guide to Prescription Drug Benefits Here you’ll find lists of drugs that have special requirements before they are covered by your plan, and an overview of how to use your prescription drug benefits	PPACA Preventive Services Some preventive medications may be covered at no cost to you when filled at a participating pharmacy with a valid prescription.
Prior Authorization, Enhanced Prior Authorization (Step Therapy), Quantity Level Limits, and Specialty Medication Lists	PPACA Preventive Medications - January 1, 2020 (includes vaccine coverage) PPACA Preventive Medications - July 1, 2020 (includes vaccine coverage)

Formulary Requirements/
Guide to Prescription Drug Benefits

Here you’ll find lists of drugs that have special requirements before they are covered by your plan, and an overview of how to use your prescription drug benefits

PPACA Preventive Services

Some preventive medications may be covered at no cost to you when filled at a participating pharmacy with a valid prescription.

Prior Authorization, Enhanced Prior Authorization (Step Therapy), Quantity Level Limits, and Specialty Medication Lists

PPACA Preventive Medications - January 1, 2020
(includes vaccine coverage)

PPACA Preventive Medications - July 1, 2020
(includes vaccine coverage)

If you have Group Coverage From Your Employer or PersonalBlue PPO

Drug Formulary	Formulary Updates
2020 Formulary (Advantage)	Advantage Formulary 2020 Opioid Updates Advantage Formulary Update January 1, 2020 Updates July 1, 2020 Updates
2020 Formulary (Elite)
2020 Formulary (Exclusive)
2020 Formulary (Value)
2020 Formulary (Value Plus)	Value Plus Formulary Update January 1, 2020 Updates July 1, 2020 Updates

Formulary Requirements/ Guide to Prescription Drug Benefits Here you’ll find lists of drugs that have special requirements before they are covered by your plan, and an overview of how to use your prescription drug benefits	PPACA Preventive Services Some preventive medications may be covered at no cost to you when filled at a participating pharmacy with a valid prescription.	QHDHP Preventive Drugs (This option is available to large groups of 100+ employees and is standard for all groups of less than 100 employees.) Check your Certificate of Coverage to see if this option applies to your QHDHP. If so, some preventive and maintenance medications will have the deductible waived, and you will be charged only a copay.
Prior Authorization, Enhanced Prior Authorization (Step Therapy), Quantity Level Limits, and Specialty Medication Lists	PPACA Preventive Medications - January 1, 2020 (includes vaccine coverage) PPACA Preventive Medications - July 1, 2020 (includes vaccine coverage)	2020 Qualified High Deductible Health Plan

Formulary Requirements/
Guide to Prescription Drug Benefits

Here you’ll find lists of drugs that have special requirements before they are covered by your plan, and an overview of how to use your prescription drug benefits

PPACA Preventive Services

Some preventive medications may be covered at no cost to you when filled at a participating pharmacy with a valid prescription.

QHDHP Preventive Drugs

(This option is available to large groups of 100+ employees and is standard for all groups of less than 100 employees.)

Check your Certificate of Coverage to see if this option applies to your QHDHP. If so, some preventive and maintenance medications will have the deductible waived, and you will be charged only a copay.

Prior Authorization, Enhanced Prior Authorization (Step Therapy), Quantity Level Limits, and Specialty Medication Lists

PPACA Preventive Medications - January 1, 2020
(includes vaccine coverage)

PPACA Preventive Medications - July 1, 2020
(includes vaccine coverage)

2020 Qualified High Deductible Health Plan

Forms

Blood Glucose Meter Program	Blood Glucose Meters
CHIP Prescription Claim	CHIP Prescription Claim Form
General Forms	Prescription Claim Form
Mail Orders	Mail Order Form

Web Content Viewer - Metadata

Web Content Viewer - Fixed Context

Web Content Viewer - Fixed Context

Web Content Viewer - Fixed Context

Prescription Drug Benefits

Plain Page Single Section DnD

Drug Lists (Formularies)

Web Content Viewer - Fixed Context

If you have Individual Coverage From Capital BlueCross or HealthCare.gov

Drug Formulary

Formulary Updates

Value Formulary

Value Formulary Update

CHIP Formulary

CHIP Formulary Update

Formulary Requirements/ Guide to Prescription Drug Benefits

PPACA Preventive Services

If you have Group Coverage From Your Employer or PersonalBlue PPO

Drug Formulary

Formulary Updates

Advantage Formulary

Advantage Formulary Update

Value Plus Formulary Update

Formulary Requirements/ Guide to Prescription Drug Benefits

PPACA Preventive Services

QHDHP Preventive Drugs

Plain Page Single Section DnD

Forms

Blood Glucose Meter Program

CHIP Prescription Claim

General Forms

Mail Orders

Formulary Requirements/
Guide to Prescription Drug Benefits

Formulary Requirements/
Guide to Prescription Drug Benefits