Custom Drug List

Refer to the Custom Drug List (PDF) when prescribing medications for Blue Cross PPO and Blue Care Network HMO members with 3-tier, 5-tier, or closed drug list plan, and also for HMO members with a 6-tier drug list plan. Under the closed drug list benefit design, drugs listed as tier 3 (non-preferred brand) are not covered unless we authorize them as medically necessary. 

Blue Cross Blue Shield of Michigan PPO plans classify all generic drugs as Tier 1. Blue Care Network HMO 6-tier plans group generic drugs into two tiers. Tier 1A preferred generics have the lowest copays. Tier 1B generics have a higher copay but are still lower than the copay for brand-name drugs. We encourage physicians to prescribe preferred medications whenever possible.

Certain drugs on the list may also require prior authorization or step therapy or quantity limits

Drug list updates

Since a drug's status may change and new drugs may be added, we also publish a list of updates to keep you informed of those changes. The Custom Drug List is updated monthly.

For the most recent drug list updates, including the Custom Drug List, read our Drug List Updates (PDF).

Drug list exclusions

The drugs on this list are not covered on the commercial Blue Cross Blue Shield drug lists. The preferred alternatives on this list have similar effectiveness, quality and safety, but at a fraction of the cost. For the most recent list of excluded drugs, read our Custom and Clinical Drug List Exclusions (PDF)

Questions? We can help!

To verify a member's benefit plan or get answers to your pharmacy-related questions, please contact us.