It includes generic, brand name, and specialty drugs as well as Preferred drugs that, when selected, will lower your out-of-pocket costs.Tiers are the different cost levels you pay for a drug. Find out how you may be able to obtain your prescriptions at the correct Low Income Subsidy (LIS) cost sharing level if you can show evidence of your LIS eligibility.If BlueCross BlueShield denied your request for coverage of (or payment for) a prescription drug, you have the right to ask us for a redetermination (appeal) of our decision. If you are a resident of a long-term care facility, we will allow you to refill your prescription until we have provided you with at least a 91 day transition supply, consistent with dispensing increment, (unless you have a prescription written for fewer days). For account specific information on plans, call your BCBSIL representative. Blue Cross and Blue Shield of Illinois (BCBSIL) offers a wide range of prescription drug plans for our clients. 711). SM BCBSWNY complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. The 2020 Medicare Formulary includes a list of prescription care drugs covered by a prescription drug plan.With over 63,000 pharmacies serving our members locally and nationally, our pharmacy network meets the pharmacy access requirements as mandated by the Centers for Medicare and Medicaid Services (CMS).Share this page with your friends and followers on these social media platforms.As a new or continuing member in our plan, you may be taking drugs that are not on our formulary. If your drug is in Tiers 2, 3 or 5, look to see if there is a generic or Preferred drug option available, and discuss these options with your doctor. These drugs, known as “Managed Not Covered” drugs, have available covered options in the same therapeutic class. Notice of Formulary Change 2020 Formulary Update; Updated September 1, 2020. 2020 Medicare Advantage Formulary; Updated September 1, 2020. Prescription Drug List (Formulary) Pharmacy Finder You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. Please contact customer service for additional information.You might qualify to get help in paying for your drugs. Title: 2020 IL PDP Basic Author: Blue Cross MedicareRx (PDP) - HCSC Insurance Services Company (HISC) Subject: 2020 Formulary (List of Covered Drugs) Approved Formulary File ID: 00020122. BCBSIL Health Insurance Marketplace HMO 6 Tier Drug List September 2020 I Introduction Members are encouraged to show this list to their physicians and pharmacists. For more recent information or other questions, please contact Blue Cross . If you are in a long-term care facility and need a drug that is not on our formulary or if your ability to get your drugs is limited, but you are past the first 90 days of membership in our plan, we will cover a 31 day emergency supply of that drug (unless you have a prescription for fewer days) while you pursue a formulary exception.If a member submits a prescription for a transition eligible drug and it is rejected at Point of Sale, a message will be relayed to the pharmacist to call for additional instructions if the member underwent a recent level of care change. from your Medicare Advantage Plan. seven (7) days a week. EHIM Non-Preferred Medication Formulary Non-Preferred ($80.00 Copay) Formulary Alternatives ... Claritin OTC(g), Zyrtec OTC(g), Allegra-D, Astelin CLEOCIN VAGINAL OVULES Cleocin Vaginal Cream(g) CLIMARA PRO Climara(g), Vivelle-DOT, or Estraderm plus a progestin CLINAC BPO Individual agents (Cleocin(g) topical and OTC BPO) We use cookies on this website to give you the best experience and measure website usage. After your first 30 day supply, we will not pay for these drugs, even if you have been a member of the plan less than 90 days. “Extra Help” from Medicare, also called the “low-income subsidy” or LIS.If you get extra help from Medicare to help pay for your Medicare prescription drug plan costs, your monthly plan premium will be lower than what it would be if you did not get extra help from Medicare. If you're buying your own insurance, use these drug lists: ... Y0074_OctBCBSMBCNWeb_2020_C CMS Accepted … You should talk to your doctor to decide if you should switch to an appropriate drug that we cover or request a formulary exception so that we will cover the drug you take. While you talk to your doctor to determine the right course of action for you, we may cover your drug in certain cases during the first 90 days you are a member of our plan.For each of your drugs that is not on our formulary or if your ability to get your drugs is limited, we will cover a temporary 30 day supply (unless you have a prescription written for fewer days) when you go to a network pharmacy. BlueCross BlueShield of Western New York (BCBSWNY) is a division of HealthNow New York Inc., an independent licensee of the Blue Cross and Blue Shield Association.