Using Your Medicare Plan
Blue Cross and Blue Shield of Illinois wants you to get the most from your plan. Understanding how it works and having the right resources can help. In this section you can find out what's covered, how to file an appeal or grievance, download the formulary, search for a pharmacy, and more.
Is It Covered
It's easy to ask questions or voice concerns about your coverage. If you have questions about what your plan covers, you can:
- Look at your Evidence of Coverage. This important notice is in the Welcome Kit you received in the mail shortly after you enrolled. It details what the plan covers, how much you pay, and more. You can also find it on the Plan Documents page.
- Call customer service at the number on the back of your member ID card. The Customer Service representative can help you understand your benefits.
Medicare Coverage Determination, Appeals and Grievances
Drugs covered by Blue Cross MedicareRx are listed in formularies (or drug lists). Each plan has its own drug list. The drug lists include generic and brand name drugs. They also have information about drug copays and limitations such as prior authorization, quantity limits and step therapy.
Drug lists can change. Most of the changes in the Drug List are new for the beginning of each year. However, during the year, we might make other changes that are allowed by Medicare rules. We will provide you with advance notice of these changes.
Use the Drug Finder tool to find the most up-to-date list of medicines covered by each plan.
Download your formulary on our Forms & Documents page.
If you need help with additional plan documents, please contact us.
Prior Authorization/Utilization Management
Drug Plan Transition
Medication Therapy Management