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