Drug formulary
BCN Advantage and BlueCaid members
Use these links to view pharmacy information for other plans:
Blue Care Network's formulary is a regularly updated list of medications that have been approved by the U.S. Food and Drug Administration. Our Pharmacy and Therapeutics Committee of Michigan, physicians, pharmacists and other experts in the diagnosis and treatment of disease and promotion of health, organize our formulary according to a drug's clinical effectiveness, safety and opportunity for cost savings.
Use the links provided to view our:
- Formulary Quick Guide for Members (PDF) — Our most commonly prescribed drugs
- Custom Formulary ( PDF)
- Custom Formulary Updates (PDF)
- Quality Interchange Program (PDF) — Our step therapy and prior authorization requirements
- Quantity Limits (PDF) — Limits to medication quantities
- Formulary Alternatives (PDF) — Formulary alternatives to nonformulary drugs
- Specialty Drug Guide (PDF) — Drugs available through our specialty vendor
- Savings Plus (PDF) — Drugs available through the Savings Plus plan
Drugs in our formulary are categorized by tiers, indicating the level of copayment required. Check your drug plan for specifics about your copayment obligation.
- Formulary Preferred (Tier 1): These drugs have a proven record of safety and effectiveness and offer the best value. They require the lowest copayment. Most generic drugs are in this tier.
- Formulary Options (Tier 2): These drugs also have a proven record of safety and effectiveness. However, since more cost-effective therapy or a generic alternative is usually available, drugs in this tier usually require a higher copayment.
- Nonformulary (Tier 3): Drugs in this tier are not on our list of approved drugs. You may pay a higher copayment or the entire cost of these drugs. Formulary alternatives are available (PDF).
Note: Only your doctor can request coverage for drugs that require prior authorization or are nonformulary and not covered under your drug benefit. To request coverage, your doctor can contact our pharmacy help desk or can submit a medication request form through Web-DENIS. BCN and your docotor must agree that the drug is medically necessary for your condition based on documentation provided.
page modified 08/03/2010