Medicare Plus Blue PPO and Prescription Blue PDP formularies

Medicare Plus Blue PPO℠ and Prescription Blue PDP℠ plans include prescription drug coverage. These plans will generally cover drugs listed in our formulary as long as:

• The drug is medically necessary
• The prescription is filled at network retail or mail-order pharmacies
• All other plan rules are followed

The formulary document provides a brief description of the plans' benefits, including any deductibles. It is updated regularly.

Please choose a plan below for formulary information.

Medicare Plus Blue PPO Vitality℠

• Medicare Plus Blue PPO Vitality Comprehensive Drug Formulary - Updated August 2012 (PDF 1.03 MB)
  
• Medicare Plus Blue PPO Vitality Formulary Changes - Updated August 2012 (PDF 135 KB)
• Medication Therapy Management Program
• Utilization Management (prior authorization, step therapy criteria, quantity limit restrictions and other programs) (PDF 109 KB)
  

Medicare Plus Blue PPO Signature℠ and Prescription Blue PDP Option A

• Medicare Plus Blue PPO Signature and Prescription Blue PDP Option A Comprehensive Drug Formulary - Updated August 2012 (PDF 1.04 MB)
• Medicare Plus Blue PPO Signature and Prescription Blue PDP Option A Formulary Changes - Updated August 2012 (PDF 138 KB)
• Medication Therapy Management Program
• Utilization Management (prior authorization, step therapy criteria, quantity limit restrictions and other programs) (PDF 109 KB)

Medicare Plus Blue PPO Assure℠ and Prescription Blue PDP Option B

• Medicare Plus Blue PPO Assure and Prescription Blue PDP Option B Comprehensive Drug Formulary - Updated June 2012 (PDF 1.03MB)
• Medicare Plus Blue PPO Assure and Prescription Blue PDP Option B Formulary Changes - Updated August 2012 (PDF 137KB)
• Medication Therapy Management Program
• Utilization Management (prior authorization, step therapy criteria, quantity limit restrictions and other programs) (PDF 120 KB)

Additional resources:

• Beers Drug Report
• Drug management programs