Drug Lists: The prescription drugs your plan covers

If you have Empire BlueCross BlueShield coverage you may need to find out if a drug you or your family needs is covered. While each plan may differ slightly, the lists below will tell you the medicines that are covered by your plan. You can search or print your drug list from the opitions below. Plus, you have access to up-to-date coverage information in your drug list, including – details about brands and generics, dosage/strength options, and information about prior authorization of your drug.
 

Formulary/Drug Lists

Benefit/Program Drug Lists

Which formulary/drug list applies to your plan?

  • If you have Individual (Single or Family) or Small Group coverage, you will find your plan’s drug list or “formulary” printed on your member ID card.
  • If you have coverage through your work, you can ask your employer directly.
  • You can also call the Customer Support number printed on your ID card.
One or more Benefit/Program Drug Lists may also apply to your plan

  • If your plan includes a benefit such as PreventiveRx or Exclusive Specialty, you will find your plan’s applicable drug lists here.
  • If you’re not sure whether these lists apply to your plan, check with your employer or call the Customer Support number printed on your ID card.

Formulary/Drug Lists

All of the drug lists in this section include our Searchable Tool functionality

 

National Drug Lists

These lists may be for you if you get your health insurance plan from an employer or if you have certain grandfathered plans. Contact the Customer Service number on your member ID card if you need assistance.

Essential Drug Lists

This list may be for you if you get your health insurance plan from an employer. Check with your employer to make sure you have Empire BlueCross BlueShield’s Essential Drug List. Or contact the Customer Service number on your member ID card if you need assistance.

Preferred Drug Lists

This list may be for you if you get your health insurance plan from an employer. Check with your employer to make sure you have one of Empire's Preferred drug lists. Or contact the Customer Service number on your member ID card if you need assistance.

Select Drug Lists

These drug lists apply to you:

Contact the Customer Service number on your member ID card if you need assistance.

2017

2016

Generic Premium Drug Lists

This list includes common generic versions of well-known brand-name drugs and some select brand-name ones.

Getting another drug added to these lists

If you are prescribed a drug that is not listed on your plan’s drug list, you may need to pay more for it because it is not covered. You or your doctor can also fill out an Online Formulary Addition Request form to ask for an exception.

Benefit/Program Drug Lists

One or more Benefit/Program Drug Lists may also apply to your plan

  • If your plan includes a benefit such as PreventiveRx or Exclusive Specialty, you will find your plan’s applicable drug lists here.
  • If you’re not sure whether these lists apply to your plan, check with your employer or call the Customer Support number printed on your ID card.

PreventiveRx Drug Lists

GenericSelect Drug List

This list may be for you if your plan includes this benefit program. Check with your employer, or contact the Customer Service number on your member ID card if you need assistance.

Half Tablet Drug List

This list may be for you if your plan includes this benefit program. Check with your employer, or contact the Customer Service number on your member ID card if you need assistance.

Exclusive Specialty Drug List

This list includes specialty drugs that must be filled through a participating specialty pharmacy in order for coverage to be provided. However, this applies only if you have a specialty pharmacy network included in your benefit.

Specialty Pharmacy Network Lists

If you’re taking a medicine that’s on our Exclusive Specialty drug list, you may need to get your prescription filled at a specialty pharmacy in order for your drug to be covered under your pharmacy benefit. If you use a pharmacy that is not in the network, your medicine may not be covered and you may have to pay the full cost.

Hemophilia Drug Therapy Network Lists

CVS\specialty and Hemophilia Treatment Centers on the list are considered in-network and will give you lower costs for your Factor treatment under the medical benefit.

How we choose the drugs on these lists

An independent group of practicing doctors, pharmacists and other health-care professionals meet often to look at new and existing drugs. They choose drugs for these lists based on a number of factors including how well they work, value to patients and safety. All drugs on these lists are approved by the Food and Drug Administration (FDA). View the latest updates from this committee.

Learn how drugs are selected for specific conditions:

More resources that may help you

 

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