Drug Coverage

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

View the Drug List

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 drug won't be 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 . 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 what medicines you are taking, including OTC drugs.

Pharmacies

Our network has many pharmacies for you to use.

View the Pharmacy Directory

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.

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 Link to the Member Handbook PDF.


Prime Therapeutics, LLC, is the pharmacy benefit manager for Blue Cross and Blue Shield of Illinois.

 

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