Blue Cross Blue Shield of Michigan / PPO Drug Lists
Who is this for?
If you need to know whether Blue Cross Blue Shield of Michigan covers your medication, check these drug lists.
Custom drug list
Use with triple-tier or closed (managed) plans only.
A triple-tier plan has three fixed copays, one for each tier of drugs. A closed or managed plan only covers Tier 1 and Tier 2 drugs. Learn more about tiers in the How do I know if my plan covers my prescription drug? article in our Help Center.
If you're not sure whether your plan uses the custom drug list, check your prescription drug benefits or call Customer Service at the number on the back of your ID card and we'll help.
- Custom Drug List Quick Guide for Members (PDF)
- Custom Drug List (complete) (PDF)
- Custom Drug List Updates (PDF)
- Custom Drug List Lookup Tool: use this tool from Medco Health to find out the tier of any medication in the custom drug list.
- Custom Drug List Prior Authorization/Step Therapy List (PDF)
Clinical drug list
If you're not sure whether you should use the clinical drug list, check your prescription drug benefits or call Customer Service at the number on the back of your ID card and we'll help.
- Clinical Drug List (PDF)
- Clinical Drug List Updates (PDF)
- Clinical Drug List Prior Authorization/Step Therapy List (PDF)
Other helpful drug lists
Quantity Limit Program Drug List (PDF)
A list of drugs that have 30- and 90-day quantity limits.
Specialty Drug Program Member Guide (PDF)
A list of drugs used to treat complex and chronic illnesses that require special handling. The guide also includes the enrollment form for ordering specialty drugs from Walgreen's Specialty Pharmacy.
15-Day Specialty Drug Limitation Program List (PDF)
A list of potent specialty drugs that have a 15-day supply limit.
Preferred Alternatives (PDF)
If a drug you've been prescribed isn't in our drug list, your doctor can use this list to find an alternative.