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Over the Counter Equivalent Exclusion Program

As a means of keeping overall prescription drug costs more affordable, prescription versions of medications that are available over-the-counter (OTC) are usually not a covered benefit through the Blue Cross and Blue Shield of Illinois prescription drug card program.
Note: This program does not apply to members who have outpatient prescription drug coverage through their medical plan, processed by BlueSCRIPT.SM

This means that:

  • members usually will not receive coverage for brand and generic prescription medications that have OTC versions available at the same prescription strength.
  • members may still purchase the medication – either by prescription or over-the-counter – but will be responsible for the full cost of the drug. Choosing to purchase the OTC version will often save members money.

Members should talk to their physician before making any changes to their current medication regimen. In addition, if members need assistance selecting an OTC version from the OTC Rx List, they should speak with their pharmacist or physician.

If you have questions about the Over the Counter Equivalent Exclusion Program, contact your Blue Cross and Blue Shield representative.

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