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Pharmacy Benefits Overview

Every Blue Advantage (HMO) and Blue Advantage (PPO) plan includes generous Part D prescription drug coverage to help with the costs of your medications.

The amount you pay depends on which drug tier your drug is in under your plan. The chart below explains what you can expect to pay for drugs in each tier in the Initial Coverage Stage.

Prescription Drug Benefits* (HMO & PPO)
Deductible	$0 pharmacy deductible for drugs in all tiers
Preferred Retail and Mail-Order Cost Sharing
Tier	One-Month Supply	Two-Month Supply	Three-Month Supply
Tier 1-Preferred Generics	$3 Copay	$6 Copay	$0 Copay
Tier 2-Generics	$12 Copay	$24 Copay	$0 Copay
Tier 3-Preferred Brand	$45 Copay	$90 Copay	$135 Copay
Tier 4-Non-Preferred Brand	$100 Copay	$200 Copay	$300 Copay
Tier 5-Specialty	33% Coinsurance	Not Offered	Not Offered
Standard Retail and Mail-Order Cost Sharing
Tier	One-Month Supply	Two-Month Supply	Three-Month Supply
Tier 1-Preferred Generics	$10 Copay	$20 Copay	$30 Copay
Tier 2-Generics	$18 Copay	$36 Copay	$54 Copay
Tier 3-Preferred Brand	$47 Copay	$94 Copay	$141 Copay
Tier 4-Non-Preferred Drug	$100 Copay	$200 Copay	$300 Copay
Tier 5-Specialty	33% Coinsurance	Not Offered	Not Offered

*For in-network pharmacies only

Download the Blue Advantage Formulary to search our list of covered drugs, see the tier and if there are any requirements for coverage. Check multiple medications and estimate your annual drug costs by using our Find & Price Prescription Drugs tool.

2020 Blue Advantage Drug
Formulary Find & Price Prescription Drugs

Blue Advantage members have options on where and how to get their medicines:

Experience the safety and convenience of home delivery with Express Scripts Pharmacy^SM. Your prescriptions are mailed directly do your door and you pay nothing for standard shipping. Plus, you may save money!
Find a local pharmacy in our broad retail network, including those that offer preferred cost-sharing. You may pay less when you choose a preferred retail pharmacy to fill your prescription!

It is important to remember that enrolling in Blue Advantage does not affect Medicare coverage for any drugs that may be covered under Medicare Part A or Part B. If you meet Medicare coverage requirements, your drugs will still be covered under Medicare Part A or Part B even though you are enrolled in Blue Advantage.

Pharmacy Benefits Overview

Prescription Drug Benefits*
(HMO & PPO)

Over-the-Counter (OTC) Benefit Program

Dental

Vision

BlueCare Telehealth

Fitness

Reward & Incentives

Pharmacy Benefits Overview

Prescription Drug Benefits* (HMO & PPO)

Over-the-Counter (OTC) Benefit Program

Dental

Vision

BlueCare Telehealth

Fitness

Reward & Incentives

Prescription Drug Benefits*
(HMO & PPO)