Drug formulary
A drug formulary lists the prescription drugs each health plan covers. These medications are approved by the Food and Drug Administration (FDA) and are selected based on safety, effectiveness, and cost. Your formulary lists the generic and brand drugs covered by Blue Shield under your prescription drug benefit. A drug formulary is also called a prescription drug list and a list of covered drugs.
Specialty drug list
These drugs are only available through a Blue Shield Network Specialty Pharmacy. Some drugs may not be available for distribution through the Network Specialty Pharmacy, and you’ll have to get them from a non-network specialty pharmacy.
Preventive drug list (ACA)
These are drugs that the Health Care Reform (Affordable Care Act or ACA) requires coverage at $0 member share of cost.
Contraceptive drug list
These are drugs and devices for contraception covered at $0 member share of cost.
HDHP Preventive drug list
These are preventive drugs that may be covered before you meet your deductible in high-deductible health plans. Check your your Evidence of Coverage or Certificate of Insurance to determine if you have this benefit.
Vaccine drug list
These are vaccines covered at participating retail pharmacies for eligible non-grandfathered plans.
Value-Based Tier drug list
These are drugs that are covered at no charge, or at an otherwise reduced cost-share for select Blue shield plans with the Value-Based Tier Drug (VBTD) benefit, Check your Evidence of Coverage or Certificate of Insurance to determine if you have this benefit.