The drug lists below are used with your health plan if all of these apply to you:
- You enrolled in a plan on your own (instead of through your employer) and
- Your plan is a "metallic" health plan, which can include a Gold, Silver, Bronze, Multi-State or Catastrophic plan.
Your prescription drug benefits through BCBSTX is based on the Generics Plus Drug List, which is a list of preferred drugs considered to be safe and cost-effective. It covers drugs for the major drug classes, but includes mostly generic drugs and fewer brand-name drugs.
View your current drug list.
Starting January 1, 2016, some changes will be made to the prescription drug benefit. View the 2016 changes.
You, or your prescribing health care provider, can ask for a Drug List exception if your drug is not on the Drug List (also known as a formulary). To request this exception, you, or your prescriber, can call the number on the back of your ID card to ask for a review. If you have a health condition that may jeopardize your life, health or keep you from regaining function, or your current drug therapy uses a non-covered drug, you, or your prescriber, may be able to ask for an expedited review process. BCBSTX will let you, and your prescriber, know the coverage decision within 24 hours after they receive your request for an expedited review. If the coverage request is denied, BCBSTX will let you and your prescriber know why it was denied and offer you a covered alternative drug (if applicable). Call the number on the back of your ID card if you have any questions.