Pharmacy Services

Blue Cross Blue Shield of Michigan

Some drugs on the formulary require prior authorization, and certain clinical criteria must be met before they can be dispensed. Other drugs are part of our step-therapy program, which means the patient must have been treated with one or more formulary agents before these drugs are covered. Both categories of drugs are marked or identified in our Formulary Quick Guide and on our Custom Formulary.

• Beers Drug Report
• Blue Cross Complete (formerly BlueCaid)
  
• Clinical Formulary
• Custom Formulary
• Medicare Plus Blue℠ & Prescription Blue℠ formularies
• New Pharmacy Programs
• Pharmacy NPI
• Potential Part D Drug-Drug Interactions (PDF)
• Prior Authorization / Step Therapy
• Specialty Pharmacy Program
• State of Michigan Formulary (PDF)

Blue Care Network

• 3-Tier + Specialty Quick Guide (PDF)
  
• Blue Cross Complete (formerly BlueCaid of Michigan) 
• BCN Advantage HMO-POS℠ Formulary
• Blue Essentials Formulary Quick Guide for Members (PDF)
• Blue Essentials Tier Drug List (PDF)
• Custom Formulary
• Custom Formulary Updates (PDF)
• Limited Prescription Drug Plan for Female Contraceptives (PDF)
  
• Pharmacy NPI
• Prior Authorization and Step-Therapy Guidelines (formerly Quality Interchange)
• Quantity Limits and Dose Optimization
  
• Request Prescription Drug Coverage
• Savings Plus Approved Drug List (PDF)
  
• Specialty Pharmacy Program

Formularies, drug guides and more are available for Personal Digital Assistants (PDAs) at epocrates.com.

Billing information for Michigan pharmacies

• Compound vehicle list (PDF)

Version D.0 — Medco Payer Sheet (Information) 

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