Drug List

(Comprehensive Formulary)

Blue MedicareRx (PDP) uses a preferred list of drugs called a comprehensive formulary. This list includes both higher cost generic drugs and brand-name drugs, all carefully selected to provide the greatest value while meeting the needs of our members.

Formulary changes

We regularly review our formularies. They may change during a calendar year if we:

If a change affects a drug you take, we will notify you at least 60 days in advance, as required by Medicare.

To view the Comprehensive Formulary, Prior Authorization and Step Therapy documents click here.

Drugs that we cannot cover

Federal law prohibits us from covering certain types of drugs, including:

  • Non-prescription drugs (also called over-the-counter drugs).
  • Drugs for treatment of anorexia, weight loss or weight gain.
  • Drugs to promote fertility.
  • Drugs for cosmetic purposes or hair growth.
  • Drugs to relieve a cough or cold symptoms.
  • Prescription vitamins and minerals (except for prenatal vitamins and fluoride preparations).
  • Drugs for treatment of sexual or erectile dysfunction (ED).

In addition, a Medicare Part D plan cannot cover:

  • Drugs that would be covered under Medicare Part A or Part B.
  • Drugs not approved by the U.S. Food and Drug Administration (FDA).
  • Off-label drug use, which means using a drug for treatments not specifically mentioned on the drug’s label.
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