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Pharmacy

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The rising cost of prescription drugs is becoming harder to swallow. That's why most Anthem health plans come with prescription coverage to help make medication more affordable. Learn more about our prescription drug benefit and valuable resources like online access to our drug list/formulary and ordering prescriptions online.  

At Anthem Blue Cross and Blue Shield and its subsidiary, HMO Nevada, many of the health plans include a prescription drug benefit with various cost-sharing requirements. Please refer to your Certificate or Benefit Booklet, and Summary of Benefits, provided with your member enrollment materials for that important information.  
Anthem offers an array of programs and services that can help manage prescription benefit costs.  

Plans And Benefits: Prescription Please refer to your plan Summary of Benefits document to determine your pharmacy and benefits coverage.
Specialty Pharmacy
If you use one or more specialty medications, learn more about our preferred specialty medication provider. Some members must use Accredo specialty pharmacy provider to obtain certain specialty medications at the in-network benefit level – click the link above to learn more. 

Home Delivery Pharmacy
If you regularly use any maintenance medication for hormone replacement or an ongoing condition such as asthma, diabetes, high blood pressure or arthritis, you'll appreciate the convenience and savings of having your prescriptions filled by the home delivery pharmacy online.  

Pharmacy and Therapeutics Committee

Anthem Drug Lists/Formularies
The Anthem Drug List/Formulary is a list of brand-name and generic medications that have been reviewed and selected by a committee of practicing doctors and clinical pharmacists for their quality and effectiveness. Anthem provides a variety of prescription drug benefits utilizing different drug lists that can be accessed below. All of Anthem’s prescription benefits also include coverage for insulin and state mandates. Please refer to your Certificate of Coverage or contact Customer Service with any questions about which drug list applies to your health plan. 

Nevada Tiered Drug List
To be used by members who have a 3- or 4- tier copay drug plan. This does not include the Nevada Generic Premium Drug or any other limited formulary drug plans. 

Nevada Tiered Drug List - Spanish

Nevada Generic Only Drug List

Nevada Generic Premium Drug List
To be used by members who have a Generic Premium drug plan. Coverage is limited to drugs on the Generic Premium Drug List/Formulary that offers enhanced coverage beyond generic drugs. In general, the Generic Premium Drug List/Formulary will include most generic drugs and limited brand name drugs. Typically no more than one or two brand-name drugs in a therapeutic class will be covered. There is also coverage for limited specialty medications.  

Nevada Non-Tiered Drug List
To be used by members who have a non-tiered drug plan such as our consumer-driven health products or Lumenos plans.  

Nevada Non-Tiered Drug List – Spanish

Search the Drug List/Formulary
This link will take you to the member sign-in for the Anthem Pharmacy Benefits Manager and allow you to search the Drug List/Formulary specific to your health plan. 

Nevada Fourth Tier Drug List
Anthem Blue Cross and Blue Shield offers a four-tier drug benefit in our group plans. This benefit provides coverage for certain self-administered injected or infused drugs, such as those used to treat hepatitis, rheumatoid arthritis and multiple sclerosis. This list can be used as a quick reference for the medications that have a 4th tier copay and is subject to change.  

Home Delivery Pharmacy Order Form
Prescription Drug Claim Form
To find these forms, members must visit the Express Scripts website after login to their health plan site. Click the link in the Refill a Prescription section after login." On the Express Scripts site, select the Claims Reimbursement Form from the Printable Forms section.  
 
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Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. In Connecticut: Anthem Health Plans, Inc. In Indiana: Anthem Insurance Companies, Inc. In Kentucky: Anthem Health Plans of Kentucky, Inc. In Maine: Anthem Health Plans of Maine, Inc. In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. In Nevada: Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc., dba HMO Nevada. In New Hampshire: Anthem Health Plans of New Hampshire, Inc. In Ohio: Community Insurance Com pany. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. In Wisconsin: Blue Cross Blue Shield of Wisconsin ("BCBSWi"), which underwrites or administers the PPO and indemnity policies; Compcare Health Services Insurance Corporation ("Compcare"), which underwrites or administers the HMO policies; and Compcare and BCBSWi collectively, which underwrite or administer the POS policies. Independent licensees of the Blue Cross and Blue Shield Association. ® ANTHEM is a registered trademark of Anthem Insurance Companies, Inc. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. Use of the Anthem Web sites constitutes your agreement with our Terms of Use