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Prescription drug benefits

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

Find a pharmacy in your network

Drug lists (formularies)

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


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)

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


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

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

2020 ACA Preventive Drug List

2020 Qualified High Deductible Health Plan - January 1, 2020

2020 Qualified High Deductible Health Plan - July 1, 2020

2021 Qualified High Deductible Health Plan - January 1, 2021

2020 Qualified High Deductible Health Plan - HSA Preventive Drug List

2020 Value-Based Drug List

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