Drug Coverage

The Blue Cross Community Family Health Plan includes coverage for selected prescription and over-the-counter (OTC) drugs, and selected medical supplies. This plan goes by a list of preferred drugs. The Drug List (sometimes called a formulary) is a list showing the drugs that can be covered by the plan. The list includes generic, brand and OTC drugs and medical supplies.

View the Drug List pdf

Drug List Updates Learn more about third-party links

As a member, you pay nothing ($0) for the items on the Drug List. Those items will be covered as long as you:

  • have a medical need for them
  • have a prescription from your doctor for them
  • fill the prescription at a network pharmacy
  • follow the plan rules

Certain drugs on the list need prior authorization. Your doctor will need to request approval before these drugs can be prescribed. Without approval, the drugs are not covered. Your doctor will choose which drug is best for you. If your doctor wants you to have a drug that is not on the list, he or she can request approval for that drug. View prior approval form pdf document. For some drugs, the plan limits the amount that will be covered. You can find out if your drug has any added conditions or limits by looking at the Drug List. The Drug List changes sometimes and a summary of recent changes are found on Drug List Updates Learn more about third-party links.

To protect your health and keep you safe, make sure your doctor and pharmacist know all the medicines you are taking, including OTC drugs.

Pharmacies

Our network has many pharmacies for you to use.

View the Pharmacy Directory pdf

MAIL-ORDER SERVICE

If you take certain prescription drugs on a regular basis, you can have them delivered to your home. The mail-order service pharmacy program provides up to a 90-day supply at one time.

View Prime Mail Order Form pdf

Emergency Contraception Changes

Beginning 12/1/2016, your plan will cover a maximum of 3 pharmacy claims per year for emergency contraception. You can receive emergency contraception at a network pharmacy of your choice without a prescription. You should visit your provider or OB-GYN to discuss birth control options such as:

  • birth control pills,
  • shots,
  • patches, or
  • long acting reversible contraception, such as the IUD.

To learn more about the plan's drug coverage, see the Member Handbook pdf or Drug List pdf for more information.

As a Blue Cross Community Family Health Plan member, you have access to wide network of retail pharmacies in Illinois. Find a pharmacypdf.

Use our Provider Finder® to search for doctors and other health care providers near you.

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