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Author: Admin | 2025-04-28
The drug lists below are used with your health plan if:You enrolled in a plan on your own (instead of through your employer), andYour plan is a "metallic" health plan, which can include a Gold, Silver, Bronze or Catastrophic plan.Your prescription drug benefits through BCBSOK are based on a Drug List, which is a list of drugs considered to be safe and cost-effective.To search for a drug name within the PDF Drug List document, use the Control and F keys on your keyboard, or go to Edit in the drop-down menu and select Find/Search. Type in the word or phrase you are looking for and click on Search.View your drug list effective January 1, 2025 (for 2025 coverage):2025 6 Tier Drug List2025 4 Tier Drug ListZero-Dollar Emergency-Use MedicationsStarting January 1, 2025, some changes will be made to the prescription drug benefit. Review the 2025 changes.View your current drug list effective January 1, 2024:2024 6 Tier Drug List2024 4 Tier Drug ListWomen's Contraceptive Coverage ListACA $0 Preventive Drug ListStarting January 1, 2024, some changes will be made to the prescription drug benefit. Review the 2024 changes.View the Commonly Prescribed Maintenance Drug List (These are drugs taken regularly for an ongoing condition).If you're already a BCBSOK member, log in to your Blue Access for MembersSM account to check your drug list and to learn more about your pharmacy benefits.You, your prescribing health care provider, or your authorized representative, can ask for a Drug List exception if your drug is not on (or is being removed from) the Drug List. To request this exception, you, your prescriber, or your authorized representative, will need to send BCBSOK documentation. To begin this process, you or your prescribing health care provider can call the number on your ID card for more information or fill out and submit the Prescription Drug Coverage Exception form. BCBSOK will let you, your prescriber (or authorized representative) know the benefit coverage decision within 72 hours of receiving your request. If the coverage request is denied, BCBSOK will let you and your prescriber (or authorized representative) know why it was denied and may advise you of a covered alternative drug (if applicable). You can also appeal the benefit determination.If you have a health condition and failure to take the medication may pose a risk to your life, health or keep you from regaining maximum function, or your current drug therapy uses a
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