Prescription Drug Lists
If you have prescription and pharmacy benefits with us, you have a drug list that lists medications covered by your plan.
While most member drug lists are below, you should log in to your Blue Access for MembersSM account to search for covered medications.
Prescriptions Covered By Your Plan
Drugs on your drug list are chosen based on their safety, cost and how well they work. While doctors are encouraged to prescribe drugs on the list, treatment decisions are between you and your doctor. If you know which drug list your plan uses, access it below. You also can review other materials about covered medications. We have quick-view guides with drugs that have dispensing limits, need pre-approvals, and more.
To find out if a prescription drug is covered by your plan, it's best to log into BAMSM and click on the Pharmacy tab. There you can search a medication and get all the details you need.
Drug List
Drugs covered by your plan and reviewed regularly by a group of doctors and pharmacists
Preventive Drugs
Prescriptions and/or over-the-counter medicine that are low-cost or free and used to prevent illness
Contraceptive Coverage
A list of products and services that may be covered under your medical or pharmacy benefits
Prior Authorization Program
List of medications that must be reviewed or pre-approved
Learn More
Step Therapy Program
Drugs that require you try a similar well-known drug first
Learn More
Dispensing Limits
Drugs that have limits on the amount of the drug you can get at one time
Learn More
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 BCBSMT 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. BCBSMT 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, BCBSMT 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. BCBSMT 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, BCBSMT 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.
Prime Therapeutics LLC provides pharmacy benefit management services for Blue Cross and Blue Shield of Montana. Blue Cross and Blue Shield of Montana, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics LLC. MyPrime.com is a pharmacy benefit website owned and operated by Prime Therapeutics LLC, a separate company providing pharmacy benefit management services for your plan.