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 PPO 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.

Read about our Medicare Advantage enhanced benefit prescription policies:

• Group Medicare Prescription Drug Plans (PDF)
• Individual Medicare Prescription Drug Plans (PDF)
• Group PPO Medicare Advantage Part D Drugs (PDF)
• Individual PPO Medicare Advantage Part D Drugs (PDF)

Additional resources

• Medicare Part D Payer Sheet (PDF) updated 1/1/2018

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).