Drug Lists: The prescription drugs your plan covers
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Which formulary/drug list applies to your plan? If you have coverage through your work, you can ask your employer directly. |
One or more Benefit/Program Drug Lists may also apply to your plan. If your plan includes a benefit such as PreventiveRx or Exclusive Specialty, you will find your plan's applicable drug lists here. |
Formulary/Drug Lists
All of the drug lists in this section include our Drug Search (Searchable) Tool functionality
Essential Drug Lists
This list may be for you if you get your health insurance plan from an employer. Check with your employer to make sure you have Anthem Blue Cross and Blue Shield’s Essential Drug List. Or contact the Customer Service number on your member ID card if you need assistance.
- Essential Drug List Medication Alternatives (3, 4 & 5 Tier plans) | Anthem Blue Cross and Blue Shield.pdf | Virginia.pdf
- Essential Drug List 3-Tier (Searchable) | Essential Drug List 3-Tier with 1a/1b (Searchable) | Anthem Blue Cross and Blue Shield.pdf | Virginia.pdf
- Essential Drug List 4-Tier (Searchable) | Essential Drug List 4-Tier with 1a/1b (Searchable) | Anthem Blue Cross and Blue Shield.pdf | Virginia.pdf
- Essential Drug List 5-Tier (Searchable) | Essential Drug List 5-Tier with 1a/1b (Searchable) | Anthem Blue Cross and Blue Shield.pdf
- Essential Drug List Medication Alternatives (3, 4 & 5 Tier plans) | Anthem Blue Cross and Blue Shield.pdf | Virginia.pdf
- Essential Drug List 3-Tier (Searchable) | Essential Drug List 3-Tier with 1a/1b (Searchable) | Anthem Blue Cross and Blue Shield.pdf | Virginia.pdf
- Essential Drug List 4-Tier (Searchable) | Essential Drug List 4-Tier with 1a/1b (Searchable) | Anthem Blue Cross and Blue Shield.pdf | Virginia.pdf
- Essential Drug List 5-Tier (Searchable) | Essential Drug List 5-Tier with 1a/1b (Searchable) | Anthem Blue Cross and Blue Shield.pdf
National Drug Lists
These lists may be for you if you get your health insurance plan from an employer, if you have certain grandfathered plans, or in some cases if your coverage is through a Small Group employer on or off the exchange. Contact the Customer Service number on your member ID card if you need assistance.
- National Drug List Medication Alternatives (3, 4 & 5 Tier plans) | Anthem Blue Cross and Blue Shield.pdf | Virginia.pdf
- National Drug List 3-Tier (Searchable) | National Drug List 3-Tier with 1a/1b (Searchable) | Anthem Blue Cross and Blue Shield.pdf | Virginia.pdf
- National Drug List 4-Tier (Searchable) | National Drug List 4-Tier with 1a/1b (Searchable) | Anthem Blue Cross and Blue Shield.pdf | Virginia.pdf
- National Drug List 5-Tier (Searchable) | National Drug List 5-Tier with 1a/1b (Searchable) | Anthem Blue Cross and Blue Shield.pdf
- National Drug List - Closed (Searchable) | Anthem Blue Cross and Blue Shield.pdf | Virginia.pdf
- National Drug List Medication Alternatives (3, 4 & 5 Tier plans) | Anthem Blue Cross and Blue Shield.pdf | Virginia.pdf
- National Drug List 3-Tier (Searchable) | National Drug List 3-Tier with 1a/1b (Searchable) | Anthem Blue Cross and Blue Shield.pdf | Virginia.pdf
- National Drug List 4-Tier (Searchable) | National Drug List 4-Tier with 1a/1b (Searchable) | Anthem Blue Cross and Blue Shield.pdf | Virginia.pdf
- National Drug List 5-Tier (Searchable) | National Drug List 5-Tier with 1a/1b (Searchable) | Anthem Blue Cross and Blue Shield.pdf
Preferred Drug Lists
Anthem has aligned the National and Preferred Drug Lists. Please refer to the National Drug List information above.
National Direct Drug Lists
These lists may be for you if you get your health insurance plan from an employer. Check with your employer to make sure you have the National Direct Drug List. Contact the Pharmacy Member Services number on your member ID card if you need assistance.
- National Direct Drug List Medication Alternatives (3, 4 & 5 Tier plans) | Anthem Blue Cross and Blue Shield.pdf | Virginia.pdf
- National Direct Drug List 3-Tier (Searchable) | National Direct Drug List 3-Tier with 1a/1b (Searchable) | Anthem Blue Cross and Blue Shield.pdf | Virginia.pdf
- National Direct Drug List 4-Tier (Searchable) | National Direct Drug List 4-Tier with 1a/1b (Searchable) | Anthem Blue Cross and Blue Shield.pdf | Virginia.pdf
- National Direct Drug List 5-Tier (Searchable) | National Direct Drug List 5-Tier with 1a/1b (Searchable) | Anthem Blue Cross and Blue Shield.pdf | Virginia.pdf
- National Direct Drug List 3-Tier (Searchable) | National Direct Drug List 3-Tier with 1a/1b (Searchable) | Anthem Blue Cross and Blue Shield.pdf | Virginia.pdf
- National Direct Drug List 4-Tier (Searchable) | National Direct Drug List 4-Tier with 1a/1b (Searchable) | Anthem Blue Cross and Blue Shield.pdf | Virginia.pdf
- National Direct Drug List 5-Tier (Searchable) | National Direct Drug List 5-Tier with 1a/1b (Searchable) | Anthem Blue Cross and Blue Shield.pdf | Virginia.pdf
New! 2022 Select Drug Lists
The following states Select Drug Lists apply to Individual plans if you purchased a plan on your state or federal Health Insurance Marketplace (also known as the exchange) or if you purchased coverage off the exchange and not through your employer.
The following states Select Drug Lists apply to Small Group plans if your coverage is through a Small Group employer on, and in some cases, off the exchange.
The following Select Drug Lists apply to Connecticut Large Group Alternative Funding plans:
Español
Contact the Pharmacy Member Services number on your ID card if you need assistance. |
Traditional Open Drug Lists
These lists may be for you if you get your health insurance plan from an employer, if you have certain grandfathered plans, or in some cases if your coverage is through a Small Group employer on or off the exchange. Contact the Customer Service number on your member ID card if you need assistance.
- Traditional Open Drug List 3-Tier (Searchable) | Traditional Open Drug List 3-Tier with 1a/1b (Searchable) | ABCBS.pdf | Virginia.pdf
- Traditional Open Drug List 4-Tier (Searchable) | Traditional Open Drug List 4-Tier with 1a/1b (Searchable) | ABCBS.pdf | Virginia.pdf | Colorado Small Group ACA.pdf
- Traditional Open Drug List 5-Tier (Searchable) | Traditional Open Drug List 5-Tier with 1a/1b (Searchable) | ABCBS.pdf
- Traditional Open Drug List 3-Tier (Searchable) | Traditional Open Drug List 3-Tier with 1a/1b (Searchable) | ABCBS.pdf | Virginia.pdf
- Traditional Open Drug List 4-Tier (Searchable) | Traditional Open Drug List 4-Tier with 1a/1b (Searchable) | ABCBS.pdf | Virginia.pdf | Colorado Small Group ACA.pdf
- Traditional Open Drug List 5-Tier (Searchable) | Traditional Open Drug List 5-Tier with 1a/1b (Searchable) | ABCBS.pdf
Generic Premium Drug Lists
The Generic Premium Drug List is no longer actively marketed and only applies to members who have not been transitioned to an alternative drug list.
Benefit/Program Drug Lists
One or more Benefit/Program Drug Lists may also apply to your plan. If your plan includes a benefit such as PreventiveRx or Exclusive Specialty, you will find your plan’s applicable drug lists here. |
PreventiveRx Drug Lists
One of these lists may apply to you if your plan includes the PreventiveRx benefit (members can receive certain preventive drugs at low or no cost). Check with your employer or contact the Customer Service number on your member ID card if you need assistance.
If you have the Essential formulary/drug list, this PreventiveRx drug list may apply to you:
- PreventiveRx Plus Drug List (Essential) | (Español)
- PreventiveRx Enhanced Drug List (Essential) | (Español)
- PreventiveRx Enhanced Drug List (Virginia) (Essential) | (Español)
If you have the National formulary/drug list, one of these PreventiveRx drug lists may apply to you:
- PreventiveRx Basic Plus Drug List | (Español)
- PreventiveRx Basic Plus Drug List (Virginia) | (Español)
If you have the National Direct formulary/drug list, one of these PreventiveRx drug lists may apply to you:
- PreventiveRx Plus Drug List (National Direct)
- PreventiveRx Plus Drug List (Virginia)
- PreventiveRx Enhanced Drug List (National Direct) | (Español)
- PreventiveRx Enhanced Drug List (Virginia) | (Español)
Anthem has aligned the National and Preferred Drug Lists. If you have the PreventiveRx Drug List (Preferred), please refer to the PreventiveRx Plus Drug List (National) above.
If you have the Select formulary/drug list, this PreventiveRx Plus drug list may apply to you:
- PreventiveRx Plus Drug List (Select) (Connecticut) | (Español)
- PreventiveRx Plus Drug List (Select) (Georgia) | (Español)
- PreventiveRx Plus Drug List (Select) (Maine) | (Español)
- PreventiveRx Plus Drug List (Select) (Virginia) | (Español)
- PreventiveRX Plus Drug List (Select) (Wisconsin) | (Español)
- PreventiveRx Plus Drug List (Select) (Connecticut) | (Español)
- PreventiveRx Plus Drug List (Select) (Georgia) | (Español)
- PreventiveRx Plus Drug List (Select) (Maine) | (Español)
- PreventiveRx Plus Drug List (Select) (Virginia) | (Español)
- PreventiveRX Plus Drug List (Select) (New Hampshire) | (Español)
- PreventiveRX Plus Drug List (Select) (Wisconsin) | (Español)
If you have the Traditional Open formulary/drug list, this PreventiveRx Enhanced drug list may apply to you:
Exclusive Specialty Drug List
This list includes the specialty drugs that must be filled through a participating specialty pharmacy in order for coverage to be provided. This list only applies if you have a specialty pharmacy network included in your benefit.
Specialty drug benefit exclusion lists
These lists of specialty medications if covered by your plan, are not covered under the pharmacy benefit. Some exceptions may apply.
- Specialty drugs not covered under the pharmacy benefit
- Specialty drugs not covered under the pharmacy benefit (Virginia)
These lists of specialty medications if covered by your plan, are not covered under the medical benefit. Some exceptions may apply.
- Specialty drugs not covered under the medical benefit
- Specialty drugs not covered under the medical benefit (Virginia)
Home Delivery and Rx Maintenance 90 Drug Lists
These lists may be for you if you refill prescriptions through home delivery or at a Rx Maintenance 90 pharmacy for maintenance drugs, which are used to treat long-term conditions like high blood pressure or diabetes.- Home Delivery and Rx Maintenance 90 Drug List | (Anthem Blue Cross and Blue Shield) | Español
- Home Delivery and Rx Maintenance 90 Drug List | (Virginia) | Español
View can also view our Rx Maintenance 90 pharmacies, where you can obtain up to a 90-day supply of your medicine, by going to the Rx Networks page.
How we choose the drugs on these lists
An independent group of practicing doctors, pharmacists and other health-care professionals meet often to look at new and existing drugs. They choose drugs for these lists based on a number of factors including how well they work, value to patients and safety. All drugs on these lists are approved by the Food and Drug Administration (FDA).
More resources that may help you
- Pharmacy Prior Authorization Information
- 2021 Nevada IND Select Drug List – Coverage Changes on Diabetes Drugs | Asthma Drugs
- Drug List Addition Request Form
- Preventive Care Flier (Anthem Blue Cross and Blue Shield) | (Virginia)
- Preventive ACA Drug List Flier (Anthem Blue Cross and Blue Shield) | (Virginia)
- Home Infusion Therapy Exclusion List | (Virginia)
- Ways to save on your drug costs | (Virginia)
- Voluntary Dose Management Programs
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