Blue Cross 2017 Pharmacy Benefit Changes

Guide to Changes in Drug Coverage for Fully Insured Members in 2017

In 2017, Blue Cross and Blue Shield of Louisiana will implement a closed formulary for non-grandfathered individual and non-grandfathered small group (2-50) plans and make annual formulary updates to drug coverage for all other members.

New covered drug list:

Affected Members: non-grandfathered individuals and non-grandfathered small group plans

Today, the Blue Cross formulary is open for all members. This means Blue Cross cover all contract-eligible prescription drugs at different cost-share levels. Starting Jan. 1, 2017, drug lists for non-grandfathered individual and non- grandfathered small group (2-50) plans will be closed. This means Blue Cross will not cover every drug, only those on the list. Continue reading “Blue Cross 2017 Pharmacy Benefit Changes”

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Learn more about how drugs are covered with Blue Cross

You can learn more about how your drugs are covered by reading lists called formularies. These lists have tiers that will help you see if there are drugs you can take that will cost you less. Tier 3 drugs cost more than Tier 2 and Tier 1 drugs.

These drug lists also show what rules may apply to your drugs. Some of these rules may include having your doctor call Blue Cross first before ordering a drug; getting a certain amount of a drug at one time; or trying other drugs first before your plan will cover a drug.

First, check your plan booklet to see how many drug tiers your plan has then go to:

  1. bcbsla.com/pharmacy
  2. Click Prescription Drug Lists
  3. Choose the 2016 Drug Formulary for your plan
  4. Look up your drug in the index to find what page it is on in the formulary

If you have questions, call the Pharmacy number on your member ID card.

Continue reading “Learn more about how drugs are covered with Blue Cross”