Pharmacy information Drug Formulary Information
Get the most coverage for your prescription drugs by using a pharmacy that's in our network. Choose from the following options to find a network pharmacy near you:
Find a network pharmacy near you
- Pharmacy Search—Essential (PDP) | Value & Enhanced (PDP)
- CVS Specialty Pharmacy for Blue MedicareRx (PDP) plans:
- Specialty pharmacy focuses on the long-term, complex treatment of chronically ill patients where treatment often involves high cost or complex drugs used to treat complex conditions.
Request a pharmacy directory be mailed to you by ordering a hard copy online. You can also get pharmacy information assistance by calling the number below.
Drug Formulary information | go back
Search a list of prescription drugs (also called a formulary) covered by our Medicare plans. Choose from the following options:
- Coverage and Pricing Tool
- Drug formulary exception forms for non covered drugs.
- Covered Over-the-Counter Insulin and Insulin Administration (PDF download)
- How to address non-coverage of a prescription drug if your health care provider or pharmacist tells you they will not cover a prescription drug in your treatment plan.
- Drug formularies (PDF download)
About the drug formulary
Our drug formulary is a list of drugs selected for their value and effectiveness. The list is selected by Blue MedicareRx in consultation with a team of professional health care providers. The formulary represents prescription therapies believed to be a necessary part of a quality treatment program. Blue MedicareRx will generally cover the drugs listed in the formulary as long as the drug is medically necessary, the prescription is filled at a network pharmacy and other plan rules are followed.
How much will I pay for my Blue MedicareRx covered drugs?
In order to receive maximum benefits from your coverage, the drugs you purchase must be included in the formulary and your prescriptions should be filled at any of our network pharmacies. However, your costs may be even less for your covered drugs if you use a network pharmacy that offers preferred cost sharing rather than a network pharmacy that offers standard cost sharing.
What if my drug is not on the formulary?
Talk to your doctor if your drug isn't on the formulary. He or she may be able to prescribe a different drug for you that is covered by the plan. If an alternative drug is not available or will not be as effective, your doctor can submit a formulary exception form to ask that the drug be covered.
Can the formulary change?
Yes, drugs may be added or removed during the year. If we remove drugs from our formulary or add restrictions to the drug, such as prior authorization, quantity limits and/or step therapy, or move a drug to a higher level in the formulary, we will notify members who take the drug at least 30 days before the change becomes effective. We may also notify members when they request a refill, at which time they would receive a 30-day supply of the drug. If the Food and Drug Administration deems a drug on our formulary to be unsafe or the drug manufacturer removes the drug from the market, we will immediately remove the drug from our formulary and provide notice to members who take the drug.
About our pharmacy network
Blue MedicareRx is supported by CVS Caremark.* Once enrolled, you’ll have access to a nationwide network of pharmacies that include major chains as well as neighborhood pharmacies. You may go to any of our network pharmacies. However, your costs may be even less for your covered drugs if you use a network pharmacy that offers preferred cost sharing rather than a network pharmacy that offers standard cost sharing.
* CVS Caremark Part D Services is an independent company providing pharmacy benefit management services.