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Pharmacy and Drug Coverage Forms

Who is this for?


If you have a Medicare health or drug plan with the Blues, these forms can help you manage and order prescription drugs.

Do you need to order prescription drugs through the mail? Are you in our Medication Therapy Management program? Or do you need help paying for a drug we don't cover? Use the forms below.

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Page Last Updated Wed Feb 25 12:51:52 EST 2015