HealthyBlue Drug Coverage

CareFirst BlueChoice uses a preferred drug list (called a formulary), which is a list of generic (Tier 1) and preferred brand-name (Tier 2) drugs. Drugs that aren't on the formulary are called non-preferred (Tier 3) and are covered as part of your plan, although you'll have to pay a higher out-of-pocket costs for these drugs.

Using Your Drug Benefit

  • You pay nothing for drugs from the HealthyBlue Select Generic Drug List.
  • All your medical and prescription expenses count toward meeting your annual deductible.
  • After you meet your deductible, you will only pay the copay — for a 90-day supply of maintenance medication, you pay only two copays (not three).
  • Prescription drugs must be filled through a retail pharmacy or the Walgreens mail service pharmacy.
  • There are no claims to file when you use a participating pharmacy.

Prescription Drugs

HealthyBlue Select Generics
(Generic Drugs)

No charge for prescriptions related to Asthma, High blood pressure, High cholesterol, Diabetes and Depression – and not subject to the deductible.

Tier 1

Generics

Tier 2

Preferred Brand Name*

The Preferred Brand Name drug list can change during your plan year. Check the most current preferred drug list.

Tier 3

Non-Preferred Brand Name*

Did You Know?

  • If the cost of your medication is less than your copayment, you pay the cost of the medication.
  • You can use your prescription drug card at more than 62,000 participating pharmacies nationwide.

Drug Search: Search our online drug database for information about cost tiers and generic alternatives.

*Prior Authorization: Some drugs may require prior authorization and/or may be subject to quantity limits. Your physician or pharmacist must call (800) 294-5979 to begin the prior authorization process.

Check the most current list of drugs that require prior authorization.