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^SM Essential, Vitality and Signature/Prescription Blue PDP^SM Option A

• Medicare Plus Blue PPO Essential, Vitality and Signature/Prescription Blue PDP Option A Comprehensive Drug Formulary (PDF)
  
• Utilization Management (prior authorization, step therapy criteria, quantity limit restrictions and other programs)
• Medication Therapy Management Program

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

• Medicare Plus Blue PPO Assure and Prescription Blue PDP Option B Comprehensive Drug Formulary (PDF)
• Utilization Management (prior authorization, step therapy criteria, quantity limit restrictions and other programs)
  
• Medication Therapy Management Program

Additional resources:

• Beers Drug Report 
• Drug management programs