Drugs, Drug Plans and Vaccines

Medicare Advantage prescription drug program

Medicare Part D prescription coverage may be included with a member's Medicare Plus Blue PPO℠ coverage (known as a Medicare Advantage prescription drug plan or as a standalone prescription drug plan).

Check the member ID card and summary of benefits for more member information.

• Medicare Advantage prescription drug program benefit summaries

Prescription drug formularies and more information

Blue Cross Blue Shield of Michigan's Pharmacy Services website provides a wealth of information about our Medicare Advantage drug formularies, as well as details about prior authorization, step therapy criteria and quantity limits.

Additional resources

• Medicare Part D payer sheet (PDF) updated 3/1/2013

Vaccine roster billing information and forms

Flu and pneumonia vaccines are covered under Medicare Part B benefits and should not be billed to the member's Medicare Part D plan.

• Roster Billing for Influenza and Pneumococcal Vaccines on the CMS-1450 (UB-04) (PDF)
• Roster Billing for Influenza and Pneumococcal Vaccines on the CMS-1500 Claim (PDF)
• BCBSM Medicare Advantage Plan Influenza A (H1N1) Immunization Roster (PDF)
• BCBSM Medicare Advantage Plan Influenza Immunization Roster (PDF)
• BCBSM Medicare Advantage Plan Pneumococcal Polysaccharide Virus (PPV) Immunization Roster (PDF)

Other vaccine coverage

Coverage for other vaccines may fall under Part A, Part B or Part D (PDF).