Future drug lists for your plan are available and will take effect on 7/1. Check what will change.

New York Drug List

The Prescription Drugs Your New York Anthem Blue Cross and Blue Shield Plan Covers

 

If you are a member with Anthem's Blue Cross and Blue Shield New York pharmacy coverage, log in and automatically connect to the current drug list that applies to your pharmacy benefits.

 

If you're not sure whether which list applies to your plan, check with your employer, or call the Pharmacy Member Services number printed on your ID card.

New York Drug Lists

Get access to up-to-date Anthem Pharmacy coverage for your New York drug list. Our drug lists include details about brands and generics, dosage/strength options, and information about prior authorization of your drug.

How We Choose The Drugs On These Lists

 

An independent group of practicing doctors, pharmacists and other health-care professionals meet regularly to review new and existing drugs.

 

The medications on your drug list are chosen 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).

Essential Drug List

 

The Anthem Blue Cross and Blue Shield Essential drug list is for New York members who receive a health insurance plan from an employer. 

 

Members, contact your employer or the Pharmacy Member Services number on your ID card if you need assistance in identifying your plan.

Search for three tier medications in these searchable lists.

 

 Searchable New York Essential Drug List

 

 Searchable New York Essential Drug List (Español)

Search for three tier medications in these searchable lists.

 

 Searchable 2023 New York Essential Drug List

 

 Searchable 2023 New York Essential Drug List (Español)

National Drug List

 

The Anthem Blue Cross and Blue Shield National drug list is for New York members who receive a health insurance plan from an employer, if they have certain grandfathered plans, or in some cases if coverage is through a Small Group employer. 

 

Members, contact your employer or the Pharmacy Member Services number on your ID card if you need assistance in identifying your plan.

National Direct Drug List

 

The Anthem Blue Cross and Blue Shield National Direct drug list is for New York members who receive a health insurance plan from an employer. 

 

Members, contact your employer or the Pharmacy Member Services number on your ID card if you need assistance in identifying your plan.

National Direct Plus Drug List

 

The Anthem Blue Cross and Blue Shield National Direct Plus drug list is for New York members who receive a health insurance plan from an employer.

 

Members, contact your employer or the Pharmacy Member Services number on your ID card if you need assistance in identifying your plan.

Select Drug List

 

The Anthem Blue Cross Blue Shield Select Drug List applies to Individual plans if you purchased a plan on state or federal Health Insurance Marketplace (also known as the exchange) or if you purchased coverage off the exchange and not through your employer.

 

New York members, contact your employer or the Pharmacy Member Services number on your ID card if you need assistance in identifying your plan.

$0 Select Drug List

 

The Anthem Blue Cross and Blue Shield $0 Select Drug List is for Individual Affordable Care Act (ACA) Plans only. This plan offers a unique benefit to receive prescriptions on this list at no cost - 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.

 

 New York $0 Select Drug List (for Individual ACA plans Only)

Traditional Open Drug List

 

The Anthem Blue Cross and Blue Shield Traditional Open drug list applies to New York members who receive a health insurance plan from an employer, if they have certain grandfathered plans, or in some cases if coverage is through a Small Group employer.  

 

Members, contact your employer or the Pharmacy Member Services number on your ID card if you need assistance in identifying your plan.

Benefit and Program Drug Lists

 

PreventiveRx Drug Lists

 

The Anthem Blue Cross and Blue Shield PreventiveRx Drug List applies to New York members who’s plan includes the PreventiveRx benefit. This benefit includes members receiving certain preventive drugs at low or no cost.

 

Members, contact your employer or the Pharmacy Member Services number on your ID card if you need assistance in identifying your plan.

Essential Plan PreventiveRx Drug Lists

 

If you have the Anthem Blue Cross and Blue Shield Essential formulary/drug list, this PreventiveRx drug list may also apply to you.

National Plan PreventiveRx Drug Lists

 

If you have the Anthem Blue Cross and Blue Shield National formulary/drug list, one of these PreventiveRx drug lists may also apply to you.

 

National Direct Plan PreventiveRx Drug Lists

 

If you have the Anthem Blue Cross and Blue Shield National Direct formulary/drug list, one of these PreventiveRx drug lists may also apply to you.

 

National Direct Plus Plan PreventiveRx Drug Lists

 

If you have the Anthem Blue Cross and Blue Shield National Direct Plus formulary/drug list, one of these PreventiveRx drug lists may also apply to you.

 

Select Plan PreventiveRx Drug Lists

 

If you use the Select formulary/drug list for Anthem Blue Cross and Blue Shield PreventiveRx Plus and 2016 Legacy PreventiveRx Plus, this PreventiveRx Plus drug list may apply to you.

 

Traditional Open Plan PreventiveRx Drug Lists

 

If you use the Anthem Blue Cross and Blue Shield Traditional Open formulary/drug list, one of these PreventiveRx drug lists may apply to you.

 

CarelonRx Specialty Pharmacy Exclusive Drug List

 

The Anthem Blue Cross and Blue Shield Exclusive Specialty Drug 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.

 

 CarelonRx Specialty Pharmacy Exclusive Drug List

BioPlus 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.

 

 BioPlus Exclusive Specialty Drug List

Medical Specialty Pharmacy Drug List

 

The Anthem Blue Cross and Blue Shield Medical Specialty Pharmacy Drug List of specialty medications are not covered under the pharmacy or medical benefit for certain groups.

 

 New York specialty drugs not covered under the pharmacy benefit

 

 New York specialty drugs not covered under the medical benefit

Home Delivery and Rx Maintenance 90 Drug List

 

The Anthem Blue Cross and Blue Shield Home Delivery and Rx Maintenance 90 Drug List is for New York members who refill prescriptions through home delivery or at a Rx Maintenance 90 pharmacy. Typically, this is for maintenance drugs used to treat long-term conditions like high blood pressure or diabetes.

 

Find an Rx Maintenance 90 pharmacy to obtain up to a 90-day supply of your medicine through on of our Rx Networks.

 

 New York Home Delivery and Rx Maintenance 90 Drug List

 

 Home Delivery and Rx Maintenance 90 Drug List (Español)

Designated Medical Specialty Pharmacy Drug List

 

 New York Designated Medical Specialty Pharmacy Drug List

Additional Benefits and Forms

 

AN INSURER SHALL PROVIDE NOTICE TO INSUREDS OF THE INTENT TO REMOVE A PRESCRIPTION DRUG FROM A FORMULARY OR ALTER DEDUCTIBLE, COPAYMENT OR COINSURANCE REQUIREMENTS IN THE UPCOMING PLAN YEAR, NINETY DAYS PRIOR TO THE START OF THE PLAN YEAR. SUCH NOTICE OF IMPENDING FORMULARY AND DEDUCTIBLE, COPAYMENT OR COINSURANCE CHANGES SHALL ALSO BE POSTED ON THE INSURER'S ONLINE FORMULARY AND IN ANY PRESCRIPTION DRUG FINDER SYSTEM THAT THE INSURER PROVIDES TO THE PUBLIC.