Drug Lists for Individual and Family and Small Group Plans
Who is this for?
If you want to see if your health plan covers a medication, check one of these drug lists, also called formularies.
These drug lists are for people who:
- Purchase their own coverage, also called individual and family plans.
- Get their health coverage through an employer with 50 or fewer full-time employees. We call these small group employer-sponsored plans.
2015 drug lists: For plans that begin on or after Jan. 1, 2015
Use these drug lists if you have one of these plans.
|Blue Cross® Premier and multi-state plans||Blue Cross® Metro Detroit EPO||Blue Cross® Partnered, Metro Detroit HMO, Select, Preferred|
|Simply Blue℠ PPO, Community Blue℠ PPO, Healthy Blue Achieve℠ PPO||BCN HMO℠, BCN Healthy Blue Living℠ HMO, Blue Elect Plus℠ HMO|
For PPO and EPO plans only
- Prior Authorization and Step Therapy Guidelines (PDF): A list of prescription drugs that require prior authorization or step therapy before our plans will cover them.
- Custom Select Quantity Limit Program (PDF): A list of medications with 30- and 90-day quantity limits.
- Custom Select Drug List Alternatives for Most Common Drug Exclusions (PDF): Use this list to find alternatives to drugs not on the Custom Select Drug List.
For HMO plans only
- Quantity Limits (PDF): A list of drugs that have limits on how much medication you can get with one prescription.
- Custom Select Drug List Prior Authorization and Step Therapy Guidelines (PDF): A list of prescription drugs that require prior authorization or step therapy before your plan will cover your medication.