Web Content Viewer - Metadata
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Breadcrumb DnD
Web Content Viewer
Your Pharmacy
Benefits
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You can view and download pharmacy information for your 2022 plan through December 31, 2022.
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Find a Doctor or Pharmacy
Search for a doctor or pharmacy in your health plan network.
You will need the name of your current health plan found on your ID card.(example: BlueJourney PPO)
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Drug Formulary List/Compare Drug Prices
Compare the cost of your drugs at participating pharmacies.
To access pricing, login to your secure member account.
Search the Ideal Formulary for drugs included in the BlueJourney Essential, Value, Premier HMO plans, the BlueJourney Prime and Classic PPO plans, and the Capital Blue Cross | WellSpan Advantage Plus PPO and Inspire HMO individual benefit plans.
- Download a Ideal Formulary listing. (updated 4/2022)
- Ideal Formulary Prior Authorization Criteria
- Ideal Formulary Step Therapy Criteria
Search the Value Formulary for drugs included in the BlueJourney PPO and BlueJourney HMO group benefit plans, as well as BlueJourney Select individual PPO plan and Capital Blue Cross | WellSpan Health Advantage individual PPO plan.
- Download a Value Formulary listing. (updated 4/2022)
- Value Formulary Prior Authorization Criteria
- Value Formulary Step Therapy Criteria
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Prescription Drug Management/Assistance
Help with Drug Costs - See if you qualify for help paying for your prescription drugs.
Out of Network Pharmacy Information - How to get reimbursed for prescriptions filled at an out-of-network pharmacy.
General Transition Notice - Explanation of the transition process of your current drugs when you switch to a different health plan.
Drug Utilization Management - If required, this process will ensure you are getting the proper drugs for your diagnosed condition.
Vaccine Finder - Are you having a difficult time finding where you can get a flu shot or the shingles vaccine? Use the Vaccine Finder to search your specific areas for what pharmacies have certain vaccines available now!
Drug Utilization Management - If required, this process will ensure you are getting the proper drugs for your diagnosed condition.
Part B Step Therapy - A process used to try a lesser expensive drug before going with the top brand drug.
Collapsible Panel DnD
Medication Therapy Management (MTM)
Medication Therapy Management is a free educational program to help control long-term conditions for members who have multiple chronic diseases.
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Prescription Drug Request Forms
Medicare Coverage Determination Form - Use this form when your doctor or pharmacist tells you a prescribed drug will not be covered by your plan.
Pharmacy Reimbursement Form - To request reimbursement for a drug purchased at an out-of-network pharmacy.
Prescription Mail Order Information
Our plan’s mail order service allows you to order at least a 30-day supply of a drug and no more than a 90-day supply.
We offer two mail order pharmacy options for your convenience.
To get information about filling your prescription by mail through Express Scripts Pharmacy, contact Express Scripts Pharmacy at 1.833.715.0946, (TYY users should call 711), 24 hours a day, 7 days a week. Or print and mail the Express Scripts mail order form.
To get information about filling your prescription by mail through AllianceRx Walgreens Prime, contact AllianceRx Walgreens Prime at 1.855.924.8421, (TYY users should call 711), 24 hours a day, 7 days a week. Or print and mail the AllianceRx Walgreens mail order form.
For more information about our plan’s mail order service, please review Chapter 5 of your Evidence of Coverage booklet.
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Updated January 4, 2022
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