This document includes a list of the drugs (formulary) for our plan which is current as of 9/1/2020. Talk to your doctor first about changing your prescription to a drug on your plans formulary. For pharmacy-related benefits questions, please call us at . In Connecticut: Anthem Health Plans, Inc. This is a list of drugs we will cover in 2020, including preferred and non-preferred drugs. In Maine: Anthem Health Plans of Maine, Inc. The formulary changes listed in the table below apply to all Anthem HealthKeepers Plus members (including those enrolled in FAMIS [the CHIP program] and Medallion [the Medicaid program]) and Anthem HealthKeepers Plus, Commonwealth Coordinated Care Plus (Anthem CCC Plus) members. The formulary changes listed in the table below apply to all Anthem HealthKeepers Plus members (including those enrolled in FAMIS [the CHIP program] and Medallion [the Medicaid program]) and Anthem HealthKeepers Plus, Commonwealth Coordinated Care Plus (Anthem CCC Plus) members. Sep 1, 2020 • State & Federal / Medicaid. Our contact information, along with the date we last updated the formulary, appears on the front and back cover pages. Independent licensees of the Blue Cross and Blue Shield Association. In Kentucky: Anthem Health Plans of Kentucky, Inc. Please read : This document contains information about the drugs we cover in this plan. When it refers to “plan” or “our plan,” it means Anthem MediBlue Local (HMO). 2020 Part D Formulary (List of Covered Drugs) with a $0 copay for Select Generics Anthem Medicare Preferred (PPO) with Senior Rx Plus . The Anthem HealthKeepers Preferred Drug List, also called a formulary, has drugs on it that are approved by the U.S. Food and Drug Administration (FDA).
In Indiana: Anthem Insurance Companies, Inc. The Initial Coverage Limit (ICL) for this plan is $4020. The Anthem MediBlue Local (HMO) plan has a $0 drug deductible.
If your patients cannot be converted to a formulary alternative, call our Pharmacy department at If you have any questions about this communication, call Provider Services at If you determine formulary alternatives are not clinically appropriate for specific patients, you will need to obtain PA to continue coverage beyond the applicable effective date.We recognize the unique aspects of patient cases. In Wisconsin: Blue Cross Blue Shield of Wisconsin (BCBSWI), which underwrites or administers the PPO and indemnity policies and underwrites the out of network benefits in POS policies offered by Compcare or WCIC; Compcare Health Services Insurance Corporation (Compcare) underwrites or administers the HMO policies and Wisconsin Collaborative Insurance Company (WCIC) underwrites or administers Well Priority HMO or POS policies. If you don’t see your medicine listed on the drug lists, you may ask for an exception at submitmyexceptionreq@anthem.com.
Anthem is a registered trademark of Anthem Insurance Companies, Inc.
In Missouri (excluding 30 counties in the Kansas City area): RightCHOICE® Managed Care, Inc. (RIT), Healthy Alliance® Life Insurance Company (HALIC), and HMO Missouri, Inc. RIT and certain affiliates administer non-HMO benefits underwritten by HALIC and HMO benefits underwritten by HMO Missouri, Inc. RIT and certain affiliates only provide administrative services for self-funded plans and do not underwrite benefits. 2020 Formulary for Open Enrollment. If you still cannot locate your drugs, your plan may not offer coverage. Anthem Blue Cross and Blue Shield is the trade name of: In Colorado Rocky Mountain Hospital and Medical Service, Inc. HMO products underwritten by HMO Colorado, Inc. These changes were reviewed and approved at the fourth quarter pharmacy and therapeutics committee meeting.No changes in preferred/nonpreferred status revision or addition to UM edit onlyABRILADA 10 MG/0.2 ML, 20 MG/0.4 ML PREFILLED SYRINGE* Medication will be added to the formulary when it is available on the market.Please review these changes and work with your Anthem HealthKeepers Plus patients and/or Anthem CCC Plus patients to transition them to formulary alternatives. Companies, Inc. Anthem HealthKeepers Plus, offered by HealthKeepers, Inc., is a health plan that contracts with the Virginia Department of Medical Assistance Services to provide Commonwealth Coordinated Care Plus (CCC Plus) benefits to enrollees. In Virginia: Anthem Health Plans of Virginia, Inc. trades as Anthem Blue Cross and Blue Shield in Virginia, and its service area is all of Virginia except for the City of Fairfax, the Town of Vienna, and the area east of State Route 123. This Formulary was updated on August 1, 2019. Use of the Anthem websites constitutes your agreement with our Terms of Use. Below is the Formulary, or drug list, for Anthem MediBlue Local (HMO) from Healthkeepers, Inc.. A formulary is a list of prescription medications that are covered under Healthkeepers, Inc.'s Most plans have 4 levels of coverage.
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