Here you can find lists of the drugs (called formularies) covered under our various plans, including prior authorization, step therapy, and our drug list changes.
As a Blue Cross of Idaho member, you have the right to ask us to make an exception to our prescription drug coverage rules. You can ask us to cover a drug that's not on our list of covered drugs, cover a drug at a lower cost-sharing level or even waive coverage restrictions. Learn more here.
You have the right to appeal a decision made about your Part D coverage.
If you enroll in a new plan or there is a drug list update that has a negative effect on you, it's called a Part D Transition.
Depending on the drug, there may be coverage limits or additional requirements for coverage. These guidelines not only help our members use their prescription medications effectively, but they help keep drug costs down.
It's important to not only take your prescription medications correctly, but to make sure you are taking appropriate drugs. To help do this, we do drug utilization reviews for all our members to ensure their prescriptions are safe, effective and not causing negative interactions with each other.
If you are taking numerous drugs at the same time, there is a risk for interaction problems, as well as increasing out-of-pocket costs. Our Medication Therapy Management Program (MTMP) can help you learn more about your medications, reduce the risk of problems and help you and your healthcare providers get the most benefit from your drugs.