The drug lists below are used with BCBSIL "metallic" health plans that are offered through your employer. These can include Platinum, Gold, Silver, or Bronze plans.
If your company has 1–50 employees, your prescription drug benefits through BCBSIL are based on a Drug List, which is a list of drugs considered to be safe and effective.
If you are a BCBSIL member, log in to your Blue Access for MembersSM account to check your drug list and learn more about your prescription drug benefits.
View your drug list effective January 1, 2025 (for 2025 coverage):
- 2025 HMO POS Drug List
- 2025 Non-HMO POS Drug List
- Zero-Dollar Emergency-Use Medications
- $0 HDHP-HSA Preventive Drug List (This applies only for Blue PPO GoldSM 113, Blue PPO GoldSM 115, Blue PPO SilverSM 133, Blue PPO SilverSM 200, Blue PPO BronzeSM 106, Blue PPO BronzeSM 132, Blue PPO BronzeSM 401, Blue Choice Preferred Gold PPOSM 113, Blue Choice Preferred Gold PPOSM 115, Blue Choice Preferred Silver PPOSM 133, Blue Choice Preferred Silver PPOSM 200, Blue Choice Preferred Bronze PPOSM 106, Blue Choice Preferred Bronze PPOSM 132, Blue Choice Preferred Bronze PPOSM 401, Blue Options GoldSM PPO 200, Blue Options SilverSM PPO 107, and Blue Options SilverSM PPO 404 plans,)
Starting January 1, 2025, some changes will be made to the prescription drug benefit. Review the 2025 changes.
View your current drug list effective January 1, 2024:
- 2024 HMO Drug List
- 2024 Non-HMO Drug List
- Contraceptive Coverage List
- ACA $0 Preventive Drug List
- $0 HDHP-HSA Preventive Drug List (This applies only for Blue PPO GoldSM 113, Blue PPO GoldSM 115, Blue PPO SilverSM 133, Blue PPO SilverSM 200, Blue PPO BronzeSM 106, Blue PPO BronzeSM 132, Blue PPO BronzeSM 401, Blue Choice Preferred Gold PPOSM 113, Blue Choice Preferred Gold PPOSM 115, Blue Choice Preferred Silver PPOSM 133, Blue Choice Preferred Silver PPOSM 200, Blue Choice Preferred Bronze PPOSM 106, Blue Choice Preferred Bronze PPOSM 132, Blue Choice Preferred Bronze PPOSM 401, Blue Options GoldSM PPO 200, Blue Options SilverSM PPO 107, and Blue Options SilverSM PPO 404 plans.)
Starting January 1, 2024, some changes will be made to the prescription drug benefit. Review the 2024 changes.
These drug lists' coverage ended December 31, 2023, with the exception of a plan with an off-cycle 2024 renewal date. Check your benefit materials for details.
Starting January 1, 2023, some changes were made to the prescription drug benefit. Review the 2023 changes.
You, your prescribing health care provider, or your authorized representative, can ask for a Drug List exception if your drug is not on (or is being removed from) the Drug List. To request this exception, you, your prescriber, or your authorized representative, will need to send BCBSIL documentation. To begin this process, you or your prescribing health care provider can call the number on your ID card for more information or fill out and submit the Prescription Drug Coverage Exception form. BCBSIL will let you, your prescriber (or authorized representative) know the benefit coverage decision within 72 hours of receiving your request. If the coverage request is denied, BCBSIL will let you and your prescriber (or authorized representative) know why it was denied and may advise you of a covered alternative drug (if applicable). You can also appeal the benefit determination.
If you have a health condition and failure to take the medication may pose a risk to your life, health or keep you from regaining maximum function, or your current drug therapy uses a non-covered drug, you, your prescriber, or your authorized representative, may be able to ask for an expedited review process. BCBSIL will let you, your prescriber (or authorized representative) know the coverage decision within 24 hours of receiving your request for an expedited review. If the coverage request is denied, BCBSIL will let you and your prescriber (or authorized representative) know why it was denied and may advise you of a covered alternative drug (if applicable). Call the number on your ID card if you have any questions. You can also appeal the benefit determination.
