Prescription drug benefits

Visit your secure account to see prescription drug benefits, check costs or start home delivery.

Find a pharmacy in your network

Formulary (covered drug list)

Individual covered drug lists
Employer covered drug lists

If you have individual coverage from Capital BlueCross or HealthCare.gov

Formulary (covered drug list)	Formulary updates
2021 formulary (Value)	Value formulary 2021 opioid updates Value formulary update January 1, 2021 updates April 1, 2021 updates
2021 formulary (CHIP)	CHIP formulary 2021 opioid updates CHIP formulary update January 1, 2021 updates April 1, 2021 updates

Formulary (covered drug list)

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, Step Therapy (ST), Quantity Level Limits, and Specialty Medication Lists	PPACA Preventive Medications - January 1, 2021 (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, Step Therapy (ST), Quantity Level Limits, and Specialty Medication Lists

PPACA Preventive Medications - January 1, 2021
(includes vaccine coverage)

If you have Group coverage from your employer or PersonalBlue PPO

Formulary (covered drug list)	Formulary updates
2021 formulary (Advantage)	Advantage formulary 2021 opioid updates Advantage formulary update January 1, 2021 updates April 1, 2021 updates
2021 formulary (Elite)¹
2021 formulary (Exclusive)¹
2021 formulary (Value)
2021 formulary (Value Plus)	Value Plus formulary 2021 opioid updates Value Plus formulary update January 1, 2021 updates April 1, 2021 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.	Value-Based Design drug list
Prior Authorization, Step Therapy (ST), Quantity Level Limits, and Specialty Medication Lists	PPACA Preventive Medications - January 1, 2021 (includes vaccine coverage) PPACA for Elite/Exclusive - July 1, 2020 (includes vaccine coverage)	2021 Qualified High Deductible Health Plan - January 1, 2021	2021 Value-Based Design drug list

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.

Value-Based Design drug list

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

PPACA Preventive Medications - January 1, 2021
(includes vaccine coverage)

PPACA for Elite/Exclusive - July 1, 2020
(includes vaccine coverage)

2021 Qualified High Deductible Health Plan - January 1, 2021

2021 Value-Based Design drug list

Forms/lists

Oral chemotherapy medication	Oral chemotherapy medication listing
Blood Glucose Meter Program	Blood glucose meters
CHIP prescription claim	CHIP prescription claim form
General forms	Prescription claim form
Mail orders	Mail order form

¹OneTouch and LifeScan products are now brand preferred products on all Capital BlueCross formularies. The formularies will reflect this shortly. Thank you for your patience.

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Prescription drug benefits

Plain Page Single Section DnD

Formulary (covered drug list)

Web Content Viewer - Fixed Context

If you have individual coverage from Capital BlueCross or HealthCare.gov

Formulary (covered drug list)

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

Formulary (covered drug list)

Formulary updates

Advantage formulary

Advantage formulary update

Value Plus formulary

Value Plus formulary update

Formulary requirements/ Guide to prescription drug benefits

PPACA Preventive Services

QHDHP Preventive Drugs

Value-Based Design drug list

Plain Page Single Section DnD

Forms/lists

Oral chemotherapy medication

Blood Glucose Meter Program

CHIP prescription claim

General forms

Mail orders

Web Content Viewer - Fixed Context

Web Content Viewer - Fixed Context

Formulary requirements/
Guide to prescription drug benefits

Formulary requirements/
Guide to prescription drug benefits