The drug lists below are used with your health plan if all of these apply to you:
- You enrolled in a plan on your own (instead of through your employer) and
- Your plan is a "metallic" health plan, which can include a Gold, Silver, Bronze or Catastrophic plan.
Your prescription drug benefits through BCBSIL are based on a Drug List, which is a list of drugs considered to be safe and cost-effective.
To search for a drug name within the PDF Drug List document, use the Control and F keys on your keyboard, or go to Edit in the drop-down menu and select Find/Search. Type in the word or phrase you are looking for and click on Search.
View your drug list effective January 1, 2023:
2023 6 Tier HMO Drug List
2023 4 Tier HMO Drug List
2023 6 Tier Non-HMO Drug List
Starting January 1, 2023, some changes will be 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, or the drug required as part of step therapy or dispensing limits has been found to be (or likely to be) not right for you or does not work as well in treating your condition. To request this exception, you, your prescriber, or your authorized representative, can call the number on the back of your ID card to ask for a review. BCBSIL will let you, your prescriber (or authorized representative) know the coverage decision within 72 hours after they receive your request. If the coverage request is denied, BCBSIL will let you and your prescriber (or authorized representative) know why it was denied and offer you a covered alternative drug (if applicable). If you have a health condition that may jeopardize your life, health or keep you from regaining 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 after they receive 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 offer you a covered alternative drug (if applicable). Call the number on the back of your ID card if you have any questions.
