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Medication Look-up
Medication Look-up

Our formularies offer members coverage for over 4,000 brand name and generic medications. Use the links below to find out if a medication is covered on the member's formulary.

Formularies

Blue MedicareRx formulary

Federal Employee Program formularies (Basic Option and Standard Option)

Medicare Advantage Formulary

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Standard formulary (for all other members with our pharmacy benefits)

Our standard formulary applies to:

  • Commercial medical plans with pharmacy benefits
  • Medex plans with the three-tier pharmacy benefit

Members who use our standard formulary typically have a 3-tier or 4-tier copayment structure as part of their prescription plan. You can also use our look-up tool for members who have any plans not listed below.

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Plans with a 3-tier prescription plan

Here’s a list of some plans that have a 3-tier prescription plan. As always, benefits vary, so please check the member’s benefits when prescribing a medication.

  • HMO Blue Premium
  • HMO Blue Basic
  • HMO Blue $1000 Deductible
  • Access Blue Basic
  • HMO Blue Essential plans
Plans with a 4-tier prescription plan

Here’s a list of some plans that have a 4-tier prescription plan. As always, benefits vary, so please check the member’s benefits when prescribing a medication.

Access Blue Basic $2000 HMO Blue New England $500 Deductible
Access Blue Basic $2000 with HCCS HMO Blue New England $500 Deductible with HCCS
Access Blue Basic Saver HMO Blue New England Basic Co-insurance
Access Blue New England Basic $2000 HMO Blue New England Basic Copayment
Access Blue New England Basic $2000 with HCCS HMO Blue New England Enhanced Value
Access Blue New England Basic Saver HMO Blue New England Options Deductible
Access Blue New England Basic Saver II HMO Blue New England Options Deductible II
Access Blue New England Saver HMO Blue New England Options Deductible III
Access Blue New England Saver $2,500 HMO Blue New England Premier Value
Access Blue New England Saver $2000 HMO Blue New England Premier Value with Co-insurance
Access Blue New England Saver $3,000 HMO Blue New England Premier Value with Co-insurance and HCCS
Blue Care Elect $3000 Deductible HMO Blue New England Premier Value with HCCS
Blue Care Elect $4500 Deductible HMO Blue New England Value Plus
Blue Care Elect Enhanced Value HMO Blue Premier Value
HMO Blue $2000 Deductible HMO Blue Value Plus
HMO Blue $2000 Deductible with HCCS Preferred Blue PPO $1000 Deductible
HMO Blue Basic Co-insurance Preferred Blue PPO $1000 Deductible with HCCS
HMO Blue Basic Copayment Preferred Blue PPO $2000 Deductible
HMO Blue Enhanced Value Preferred Blue PPO $2000 Deductible with HCCS
HMO Blue NE $3000 Deductible Preferred Blue PPO $500 Deductible
HMO Blue NE $3000 Deductible with HCCS Preferred Blue PPO $500 Deductible with HCCS
HMO Blue New England $1,000 Deductible with Copay with HCCS Preferred Blue PPO Basic $2000
HMO Blue New England $1,500 Deductible with HCCS Preferred Blue PPO Basic $2000 with HCCS
HMO Blue New England $1000 Deductible Preferred Blue PPO Basic Co-insurance
HMO Blue New England $1000 Deductible with Co-insurance Preferred Blue PPO Basic Copayment
HMO Blue New England $1000 Deductible with Co-insurance and HCCS Preferred Blue PPO Basic Saver
HMO Blue New England $1000 Deductible with Copayment Preferred Blue PPO Options
HMO Blue New England $1000 Deductible with HCCS Preferred Blue PPO Options Deductible II
HMO Blue New England $1500 Deductible Preferred Blue PPO Options Deductible III
HMO Blue New England $2000 Deductible Preferred Blue PPO Saver $1500
HMO Blue New England $2000 Deductible with Copayment Preferred Blue PPO Saver $2000
HMO Blue New England $2000 Deductible with HCCS Preferred Blue PPO Saver $3000

Standard formulary look-up tool
You can also use our search feature to look-up coverage for a medication.

FIXME: SearchPharmacyPortlet
Drug:
Strength:
Dosage Form:
Prior Authorization:
Quality Care Dosing (QCD):
(Maximum Quantity per Rx)
Tier:
Notes:
 
Select a tier structure
Enter medication name (minimum 3 letters)
Sorry. No matches were found.
Medication Tier (copay level) Covered alternative Prior authorization Quality care dosing
Select a drug group and drug sub-group (if applicable) from the list and click Search.
Select a tier structure:
Select a drug group:
Select a drug sub-group:
 
Sorry. No matches were found.
Medication Tier (copay level) Covered alternative Prior authorization Quality care dosing