December 2022

Starting Feb. 1, 2023, we’re changing how we cover some drugs

Starting Feb. 1, 2023, we’re changing how we cover some medications on the drug lists associated with our prescription drug plans for Blue Cross Blue Shield of Michigan and Blue Care Network commerical members. These changes are listed below and apply to both the brand name and any available generic equivalents for drug lists where the drugs are currently covered. No changes will apply if a drug isn’t currently covered.

We’ll encourage members to discuss their treatment options with their health care provider if they have any concerns.

Drug	Affected drug list	Common use	Coverage or requirement change
Bydureon^® Byetta^® Ozempic^® Rybelsus^® Trulicity^® Victoza^®	All (where the drug is currently covered)	Diabetes	Will have new coverage requirements for members new to treatment Coverage will require the following: Being used for the treatment of Type 2 diabetes or Trial of one generic or preferred medication for the treatment of Type 2 diabetes
Wegovy^®	Preferred only	Weight management	Will have a higher copayment
Clenpiq^® Moviprep^® Plenvu^® Suprep^® Sutab^®	All (where the drug is currently covered)	Bowel preparation	Will have quantity limit of 2 fills per 365 days

For a complete list of drugs and coverage requirements go to bcbsm.com/pharmacy.

No portion of this publication may be copied without the express written permission of Blue Cross Blue Shield of Michigan, except that BCBSM participating health care providers may make copies for their personal use. In no event may any portion of this publication be copied or reprinted and used for commercial purposes by any party other than BCBSM.

*CPT codes, descriptions and two-digit numeric modifiers only are copyright 2021 American Medical Association. All rights reserved.