Carefirst drug list

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Faculty and Staff pay the prescription drug amounts as shown in the charts below. A non-formulary brand drug is one that is not on that list. Explore Express Scripts prescription plan details, check medication prices, and see what pharmacies are in-network here.

Home delivery through Express Scripts means more savings, convenience, and peace of mind. To help you stay healthy, you can receive vaccinations conveniently administered at your participating retail pharmacy through the prescription plan.

Contact your network pharmacy in advance to inquire about vaccine availability, age restrictions and current vaccination schedules.

Present your Express Scripts membership card to the pharmacist at the time of service. The university wants to help you use your prescription drug benefits wisely. The following programs will help you get the best medication at the right price:. If your medication needs approval, either you or your pharmacist will need to let your doctor know. Your doctor might switch your therapy to another drug that does not require prior authorization, step therapy, or quantity limitations by calling Express Scripts at to start the approval process.

If you choose medical coverage through Kaiser Permanente, your prescriptions will be processed by Kaiser Permanente. This chart provides your out-of-pocket copays for prescription drugs with Kaiser Permanente. Call Member Services for more information.

Formularies are developed to meet the needs of most members based on the most commonly prescribed drugs, including certain prescription drugs that Medicare requires that we cover.

If the change affects a drug you take, we will notify you before the change is effective. However, if the U. Food and Drug Administration FDA deems a drug on our formulary to be unsafe, or if the drug's manufacturer removes the drug from the market, we may immediately remove the drug from the CareFirst BlueCross BlueShield Advantage DualPrime Part D formulary and notify all affected members as soon as possible.

If you have questions using this Formulary or if you would like to be mailed a hard copy of the Formulary, please call Member Services at , 24 hours a day, 7 days a week.

TTY users please call Download a copy of our Prior Authorization. Download a copy of our Step-Therapy Criteria. Download a copy of our Formulary Changes. You can only get transition fills for drugs you were already taking before switching plans or before your existing plan changed its coverage.

As a new or continuing member in our plan you may be taking drugs that are not on our formulary. Or, you may be taking a drug that is on our formulary but your ability to get it is limited. For example, you may need a prior authorization from us before you can fill your prescription. You should talk to your doctor to decide if you should switch to an appropriate drug that we cover or request a formulary exception so that we will cover the drug.

While you talk to your doctor to determine the right course of action for you, we may cover your drug in certain cases during the first 90 days you are a member of our plan.

For each drug that is not on our formulary, or if your ability to get your drugs is limited, we will cover a temporary day supply. After your first day supply, we will not pay for these drugs, even if you have been a member of the plan less than 90 days.

If you are a resident of a long-term care facility and you need a drug that is not on our formulary or if your ability to get your drugs is limited, but you are past the first 90 days of membership in our plan, we will cover a day emergency supply of that drug while you pursue a formulary exception. If you experience a level of care change such as being discharged or admitted to a long-term care facility , your physician or pharmacy can request a one-time prescription override.

This one-time override will provide you with temporary coverage up to a day supply for the applicable drug s.

Below are the timeframes and allotments of medication that you can receive as you change living situations. The transition supply allows you time to talk to your doctor or other prescriber about pursuing other options available to you within our formulary.

Your plan cannot continue to pay for these medications under the transition policy, even if you have been a member for less than 90 days following your one-month transition supply. If you receive a transition supply, you will receive a letter from your plan notifying you that you have received a temporary supply of your prescription drug.

If your prescription is not listed on our formulary, ie.

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Toggle navigation. Prescription Drug Plan. CareFirst makes it easy to get the prescription drug care you need: Coverage for nearly 5, drugs Find out if a specific drug is covered, what cost-share tier it falls under and if any restrictions apply Locate a participating pharmacy near you Personalized care management notices detailing cost savings opportunities, safety alerts and important drug information Fast, convenient mail prescription delivery to home, office or CVS location Drug List Find a Pharmacy Preventive Drug List Note: The drug list is not an all-inclusive list and is subject to change.

Mail Service Pharmacy. Our Mail Service Pharmacy is a convenient and economical option that gives you access to: Convenient, dependable delivery service to your home or location of choice at no additional cost. Refill your prescription online, by phone or by email. Check account balances and make payments by phone. Email notifications of your order status. A new health care carrier means a new drug plan. The steps below will help make a smooth transition when you move to a new health insurance provider.

Toggle navigation. Prescription Drug Plan. CareFirst makes it easy to get the prescription drug care you need: Coverage for nearly 5, drugs Find out if a specific drug is covered, what cost-share tier it falls under and if any restrictions apply Locate a participating pharmacy near you Personalized care management notices detailing cost savings opportunities, safety alerts and important drug information Fast, convenient mail prescription delivery to home, office or CVS location Drug List Find a Pharmacy Preventive Drug List Note: The drug list is not an all-inclusive list and is subject to change.

Mail Service Pharmacy. Our Mail Service Pharmacy is a convenient and economical option that gives you access to: Convenient, dependable delivery service to your home or location of choice at no additional cost. Refill your prescription online, by phone or by email.

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