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 Empire BlueCross BlueShield’s Essential Drug List. Contact the Pharmacy Member Services number on your ID card if you need assistance.
- Essential Drug List Medication Alternatives | EBCBS.pdf | EBC.pdf
- Essential Drug List (Searchable) | EBCBS.pdf | EBC.pdf
Español
- Essential Drug List Medication Alternatives | EBCBS.pdf | EBC.pdf
- Essential Drug List (Searchable) | EBCBS.pdf | EBC.pdf
For Fully Insured members in New York renewing in 2023:
- 2023 Essential Drug List Medication Alternatives (NY) | 2023 EBCBS.pdf | 2023 EBC.pdf
- 2023 Essential Drug List (NY) (Searchable) | 2023 EBCBS.pdf | 2023 EBC.pdf
Espanol
- 2023 Essential Drug List Medication Alternatives (NY) | 2023 EBCBS.pdf | 2023 EBC.pdf
- 2023 Essential Drug List (NY) (Searchable) | 2023 EBCBS.pdf | 2023 EBC.pdf
National Drug Lists
These lists may be for you if you get your health insurance plan from an employer or if you have certain grandfathered plans. Contact the Pharmacy Member Services number on your ID card if you need assistance.
- National Drug List Medication Alternatives (3, 4 & 5 Tier plans) | EBCBS.pdf | EBC.pdf
- National Drug List (Searchable) | EBCBS.pdf | EBC.pdf
- National Drug List - Closed (Searchable) | EBCBS.pdf | EBC.pdf
Espanol
- National Drug List Medication Alternatives (3, 4 & 5 Tier plans) | EBCBS.pdf | EBC.pdf
- National Drug List (Searchable) | EBCBS.pdf | EBC.pdf
For Fully Insured members in New York renewing in 2023:
- 2023 National Drug List Medication Alternatives (NY) | 2023 EBCBS.pdf | 2023 EBC.pdf
- 2023 National Drug List (NY) (Searchable) | 2023 EBCBS.pdf | 2023 EBC.pdf
Espanol
- 2023 National Drug List Medication Alternatives (NY) | 2023 EBCBS.pdf | 2023 EBC.pdf
- 2023 National Drug List (NY) (Searchable) | 2023 EBCBS.pdf | 2023 EBC.pdf
Preferred Drug List
Empire 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 Drug List Medication Alternatives (3, 4 & 5 Tier plans) | EBCBS.pdf | EBC.pdf
- National Direct Drug List (Searchable) | EBCBS.pdf | EBC.pdf
Espanol
- National Drug List Medication Alternatives (3, 4 & 5 Tier plans) | EBCBS.pdf | EBC.pdf
- National Direct Drug List (Searchable) | EBCBS.pdf | EBC.pdf
Select Drug Lists
The $0 Select Drug List is for Individual Affordable Care Act (ACA) Plans only. Your plan offers a unique benefit to you - you may be able to receive the prescriptions on this list at no cost to you - without a copay and without having to first meet a deductible. For HSA-compatible and Catastrophic plans the deductible must be met before the medications are available at no cost.This version of the Select Drug List applies 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:
- New! 2023 Select Drug List (Searchable) | EBCBS (PDF) | EBCBS without contraceptives (PDF) | EBC (PDF) | EBC without contraceptives (PDF)
- 2022 Select Drug List (Searchable) | EBCBS (PDF) | EBCBS without contraceptives (PDF) | EBC (PDF) | EBC without contraceptives (PDF)
This version of the Select Drug List applies to Small Group plans if your coverage is through a Small Group employer on, and in some cases, off the exchange.
- New! 2023 Select Drug List (Searchable) | EBCBS (PDF) | EBCBS without contraceptives (PDF) | EBC (PDF) | EBC without contraceptives (PDF)
- 2022 Select Drug List (Searchable) | EBCBS (PDF) | EBCBS without contraceptives (PDF) | EBC (PDF) | EBC without contraceptives (PDF)
Espanol
- New! 2023 Individual Select Drug List (Searchable) | EBCBS (PDF) | EBCBS without contraceptives (PDF) | EBC (PDF) | EBC without contraceptives (PDF)
- 2022 Individual Select Drug List (Searchable) | EBCBS (PDF) | EBCBS without contraceptives (PDF) | EBC (PDF) | EBC without contraceptives (PDF)
- New! 2023 Small Group Select Drug List (Searchable) | EBCBS (PDF) | EBCBS without contraceptives (PDF) | EBC (PDF) | EBC without contraceptives (PDF)
- 2022 Small Group Select Drug List (Searchable) | EBCBS (PDF) | EBCBS without contraceptives (PDF) | EBC (PDF) | EBC without contraceptives (PDF)
Contact the Customer Service number on your member 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 or if you have certain grandfathered plans. Contact the Customer Service number on your member ID card if you need assistance.
- Traditional Open Drug List 3-tier (Searchable) | (EBCBS.pdf) | EBCBS without contraceptives (PDF) | (EBC.pdf) | EBC without contraceptives (PDF)
Espanol
- Traditional Open Drug List 3-tier (Searchable) | (EBCBS.pdf) | EBCBS without contraceptives (PDF) | (EBC.pdf) | EBC without contraceptives (PDF)
For Fully Insured members in New York renewing in 2023:
- 2023 Traditional Open Drug List 3-tier (NY) (Searchable) | 2023 EBCBS.pdf | 2023 EBCBS without contraceptives (PDF) | 2023 EBC.pdf | 2023 EBC without contraceptives (PDF)
Espanol
- 2023 Traditional Open Drug List 3-tier (NY) (Searchable) | 2023 EBCBS.pdf | 2023 EBCBS without contraceptives (PDF) | 2023 EBC.pdf | 2023 EBC without contraceptives (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 Member Services number on your ID card if you need assistance.
If you have the Essential formulary/drug list, one of these PreventiveRx drug lists may apply to you:
PreventiveRx Plus
- PreventiveRx Plus Plan Drug List (Essential) (EBCBS) | (Español)
- PreventiveRx Plus Plan Drug List (Essential) (EBC) | (Español)
Legacy PreventiveRx Plus 2016
- Legacy PreventiveRx Plus Plan Drug List (Essential) (EBCBS) | (Español)
- Legacy PreventiveRx Plus Plan Drug List (Essential) (EBC) | (Español)
If you have the National formulary/drug list, one of these PreventiveRx drug lists may apply to you:
PreventiveRx Plus
- PreventiveRx Plus Drug List (EBCBS) | (Español) | (EBC) | (Español)
- PreventiveRx Basic Plus Drug List (EBCBS) | (Español)
- PreventiveRx Basic Plus Drug List (EBC) | (Español)
- PreventiveRx Expanded Drug List (EBCBS) | (Español)
- PreventiveRx Enhanced Drug List (EBC) | (Español)
- PreventiveRx Enhanced Drug List (EBCBS) | (Español) (EBCBS) | (Español)
- PreventiveRx Expanded Drug List (EBC) | (Español)
Legacy PreventiveRx Plus 2016
- Legacy PreventiveRx Plus Drug List (EBCBS) | (Español)
- Legacy PreventiveRx Plus Drug List (EBC) | (Español)
If you have the National Direct formulary/drug list, one of these PreventiveRx drug lists may apply to you:
PreventiveRx Plus
Legacy PreventiveRx Plus 2016
For PreventiveRx Plus and if you have the Select formulary/drug list, this PreventiveRx Plus drug list may apply to you:
- PreventiveRx Plus Plan Drug List (Select) (EBCBS) | (Español)
- PreventiveRx Plus Plan Drug List (Select) (EBC) | (Español)
For Legacy PreventiveRx Plus 2016 and if you have the Select formulary/drug list, this PreventiveRx Plus drug list may apply to you:
- Legacy PreventiveRx Plus Plan Drug List (Select) (EBCBS) | (Español)
- Legacy PreventiveRx Plus Plan Drug List (Select) (EBC) | (Español)
If you have the Traditional Open formulary/drug list, one of these PreventiveRx drug lists may apply to you:
PreventiveRx Plus
- PreventiveRx Plus Plan Drug List (Select) (EBCBS) | (Español)
- PreventiveRx Plus Plan Drug List (Select) (EBC) | (Español)
Legacy PreventiveRx Plus 2016
- Legacy PreventiveRx Plus Plan Drug List (Select) (EBCBS) | (Español)
- Legacy PreventiveRx Plus Plan Drug List (Select) (EBC) | (Español)
- PreventiveRx Enhanced Drug List (Traditional Open) (EBCBS) | (Español)
- PreventiveRx Enhanced Drug List (Traditional Open) (EBC) | (Español)
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.
Medical Specialty Pharmacy Drug Lists
These lists of specialty medications are not covered under the pharmacy benefit for certain groups.
- Specialty drugs not covered under the pharmacy benefit (EBCBS)
- Specialty drugs not covered under the pharmacy benefit (EBC)
These lists of specialty medications are not covered under the medical benefit for certain groups.
- Specialty drugs not covered under the medical benefit (EBCBS)
- Specialty drugs not covered under the medical benefit (EBC)
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 (EBCBS) | Español
- Home Delivery and Rx Maintenance 90 Drug List (EBC) | 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.
Designated Medical Specialty Pharmacy Drug List
- Designated Medical Specialty Pharmacy Drug List (EBCBS)
- Designated Medical Specialty Pharmacy Drug List (EBC)
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
- Covered Contraceptives For Members Without Prescription Drug Coverage
- Pharmacy Prior Authorization Information
- Drug List Addition Request Form
- Preventive Care Flier (EBCBS) | (EBC)
- Preventive ACA Drug List Flier (EBCBS) | (EBC)
- Brand Contraceptive Copay Waiver Form (EBCBS) | (EBC)
- Breast Cancer Copay Waiver Form (EBCBS) | (EBC)
- Medical Specialty Pharmacy Drug List (EBCBS) | (EBC)
- ACA Contraceptive for Religious Affiliate Groups (EBCBS) | (EBC)
- Home Infusion Therapy Exclusion List
- Voluntary Dose Management Programs
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