Group Medicare Prescription (Part D or MAPD) plans with Senior Rx Plus
Covered Part D Drugs (Updated on 09/01/2023):
These drug lists contain the Part D eligible drugs which are covered by your plan. You can find the name of your Part D drug list by looking in the bottom left corner of the benefit chart in your Group Medicare Part D or MAPD plan Evidence of Coverage.
- Part D Drug List – B3
- Part D Drug List - B4
- Part D Drug List - B5
- Part D Drug List - E3
- Part D Drug List - E4
- Part D Drug List - E5
- Part D Drug List - P3
- Part D Drug List - P4 LAPRA
- Part D Drug List - P4
- Part D Drug List - P5
- Part D Drug List - V3
- Part D Drug List - V4
- Part D Drug List - V5
The Part D Formulary posted on this web-page includes a list of Select Generic drugs. Some plans include Select Generic drugs at reduced copays. Please check the benefit chart in your Group Medicare Part D or MAPD plan Evidence of Coverage to see if your plan includes the Select Generic benefit.
- Extra Covered Drugs - ECDHLP (High + Lifestyle Premier)
- Extra Covered Drugs - ECDMLP (Medium + Lifestyle Premier)
Extra Covered Drugs (Updated on 01/01/2023):
These drug lists contain the non-Part D eligible drugs which are covered by your Senior Rx Plus supplemental drug benefits. You can find the name of your Extra Covered Drugs option by looking in the bottom left corner of the benefit chart in your Group Medicare Part D or MAPD plan Evidence of Coverage. If you have ECDN coverage that means you do not have coverage for drugs which are not Part D eligible.
Utilization Management (Updated on 01/01/2023):
These documents provide criteria information on Prior Authorization and Step Therapy.
If you have questions about your plan's drug coverage, please call Customer Service at the number on the back of your membership card.
The Formulary may change at any time. You will receive notice when necessary.
Anthem Blue Cross is an HMO plan with a Medicare contract. Enrollment in Anthem Blue Cross depends
on contract renewal. Anthem Blue Cross Life and Health Insurance Company is an LPPO and PDP plan
with a Medicare contract. Enrollment in Anthem Blue Cross Life and Health Insurance Company depends
on contract renewal.
Y0114_18_34110_I 12/18/2017