Drug List Selection
 

Drug Lists: The prescription drugs your plan covers

If you are a member with Empire BlueCross BlueShield’s pharmacy coverage, click on the link below to log in and automatically connect to the drug list that applies to your pharmacy benefits. You can also learn more about some of our online tools, like pricing a drug, by clicking on the link to the videos.
 
You can search or print your drug list from the options below. Plus, you have access to up-to-date coverage information in your drug list, including – details about brands and generics, dosage/strength options, and information about prior authorization of your drug. If you're not sure whether these lists apply to your plan, check with your employer or call the Customer Support number printed on your ID card.
 

Formulary/Drug Lists

Benefit/Program Drug Lists

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.

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For Fully Insured members in New York renewing in 2023:

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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.

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For Fully Insured members in New York renewing in 2023:

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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.

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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:

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.

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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.

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For Fully Insured members in New York renewing in 2023:

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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

Legacy PreventiveRx Plus 2016

If you have the National formulary/drug list, one of these PreventiveRx drug lists may apply to you:

PreventiveRx Plus

Legacy PreventiveRx Plus 2016

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:

For Legacy PreventiveRx Plus 2016 and if you have the Select formulary/drug list, this PreventiveRx Plus drug list may apply to you:

If you have the Traditional Open formulary/drug list, one of these PreventiveRx drug lists may apply to you:

PreventiveRx Plus

Legacy PreventiveRx Plus 2016

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.

These lists of specialty medications are not covered under the medical benefit for certain groups.

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.

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

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

 

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