Prescription Drug Benefits

Log in to your secure member account to see your prescription drug benefits.

Find a pharmacy in your network
Pharmacy Directory (Effective January 1, 2020)

Drug Lists

If you have:

Group Coverage From Your Employer 
or PersonalBlue PPO
Drug Formulary
 2019 Formulary (Open/Closed) 
2020 Formulary (Advantage) 
2020 Formulary (Elite)
2020 Formulary (Exclusive) 
2020 Formulary (Value) 
2020 Formulary (Value Plus)
Formulary Updates

Open/Closed Formulary

Advantage & Value Plus Formulary Update
Prior Authorization, Enhanced Prior Authorization (Step Therapy), Quantity Level Limits, and Specialty Medication Lists
 2019 Pharmacy Benefit Information (for open/closed formulary)
PPACA Preventive Services

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

 PPACA Preventive Medications 
(includes vaccine coverage)
QHDHP Preventive Drugs

(In 2019, this option is available only to large groups of 100+ employees.)

If elected by your employer, some preventive and maintenance medications will have the deductible waived, and you will be charged only a copay.

 QHDHP Preventive Medications 

If you have:

Individual Coverage From Capital BlueCross or HealthCare.gov
Drug Formulary
 2019 Formulary (Selectively Closed) 
2020 Formulary (Value)
Formulary Updates

Selectively Closed Formulary

Value Formulary Update
Prior Authorization, Enhanced Prior Authorization (Step Therapy), Quantity Level Limits, and Specialty Medication Lists
 2019 Pharmacy Benefit Information (for selectively closed formulary)
PPACA Preventive Services

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

 PPACA Preventive Medications 
(includes vaccine coverage)
QHDHP Preventive Drugs

(In 2019, this option is available only to large groups of 100+ employees.)

If elected by your employer, some preventive and maintenance medications will have the deductible waived, and you will be charged only a copay.

 Not applicable 

Forms

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

Mail Order Form (English)

Mail Order Form (Español)

On behalf of Capital BlueCross, CVS/caremark™ assists in the administration of our prescription drug program. CVS/caremark is an independent pharmacy benefit manager.

On behalf of Capital BlueCross, AllianceRx Walgreens Prime, an independent company by Walgreens Specialty Pharmacy Holdings, LLC, assists in dispensing specialty medications for our members.