If your company has 150 employees, your prescription drug benefits through BCBSIL may be based on the Basic Drug List, Basic Annual Drug List, Enhanced Drug List or the Enhanced Annual Drug List. No go on the $25. See how your Service Benefit Plan coverage works with different types of prescription drugs. There are many types of health plans. They have several weight loss procedures that they cover. Quantity Management - This program limits the amount we cover for certain drugs. They don't cover it nor is it a prior authorization (?). Then all the madness hit. The lowest GoodRx price for the most common version of Wegovy is around $1,318.90, 16% off the average retail price of $1,576.73. I had to have him send it back. Call or visit your local county human services office. These health plans are not a "metallic" health plan and were effective before January 1, 2014. If your company has 51 or more employees, your prescription drug benefits through BCBSIL may be based on one of the following drug lists. For groups that, in 2013, had a $5000 lifetime maximum and were able to carry this over due to updates to the Affordable Care Act, this benefit will remain available. To request this exception, you, your prescriber, or your authorizedrepresentative, can call the number on the back of your ID card to ask for a review. Does Blue Cross Blue Shield Cover Weight Loss Injections These medications are used for those who have lost weight, but are still overweight. Specialty Pharmacy Program For members with complex health conditions who need specialty drugs, you can get access to our Specialty Drug Program. One option is Adobe Reader which has a built-in reader. By accepting all cookies, you agree to our use of cookies to deliver and maintain our services and site, improve the quality of Reddit, personalize Reddit content and advertising, and measure the effectiveness of advertising. Atorvastatin Calcium. Log In to the Shopping Cart, Need to Make a Payment? I am 65, trying either to switch plans at open enrollment. It typically includes the most commonly prescribed drugsboth brand name and genericand shows how much you pay for each drug. Note: February 22, 2023 . Check to see if the new medication is on the medication list. Drug List. Your favorite communities and start taking part in conversations formulary/preferred medication list could give you inaccurate information based the. written by OC Staff Blue Cross Blue Shield of Texas (BCBSTX) covers weight loss surgery. account to check your drug list and learn more about your prescription drug benefits. Some people may have other health conditions that make them need to lose weight, and Blue Cross Blue Shield of North Dakota is there to cover these conditions. Read More. Please review the terms of use and privacy policies of the new site you will be visiting. Y The drug list below is used with your health plan if all of these apply to you: Your prescription drug benefits through BCBSIL are based on the Basic Drug List or the Basic Annual Drug List, which is a list of drugs considered to be safe and effective. Fraud and Abuse Blue Cross and Blue Shield of Texas, a Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). 72 hours After they receive your request feed my family and privacy.. Thyroid C-cell tumors in rodents < > stream review the 2023 changes ). These can include, Understanding Health Care Costs and Quality, Provider Finder -Network Selection Criteria, HMO Provider Network Important Information, Making Your Health Insurance Work For You, Prescription Drug Changes and Pharmacy Information, Machine Readable Files for Transparency in Coverage, 2023 Basic Annual Drug List Updates Summary, 2023 Enhanced Annual Drug List Updates Summary, 2023 Multi-Tier Basic Drug List Updates Summary, 2023 Multi-Tier Basic Annual Drug List Updates Summary, 2023 Multi-Tier Enhanced Drug List Updates Summary, 2023 Multi-Tier Enhanced Annual Drug List, 2023 Multi-Tier Enhanced Annual Drug List Updates Summary, 2023 In-Vitro Fertilization (IVF) Drug List. Consider if there's another medication they could take. This is a list of preferred drugs which includes brand drugs and a partial listing of generic drugs. I have Blue Cross Blue Shield FEP (federal employee program) health insurance. The most popular procedure is the Injection Therapy for Weight Loss called Insulin-Secreting Injections (ISIs). 2 3 comments Best Add a Comment is wegovy covered by blue cross blue shield. Enjoy free standard shipping, refill reminders, and auto-refill. These can include, Understanding Health Care Costs and Quality, Provider Finder -Network Selection Criteria, HMO Provider Network Important Information, Making Your Health Insurance Work For You, Prescription Drug Changes and Pharmacy Information, Machine Readable Files for Transparency in Coverage, 2023 Basic Annual Drug List Updates Summary, 2023 Enhanced Annual Drug List Updates Summary, 2023 Multi-Tier Basic Drug List Updates Summary, 2023 Multi-Tier Basic Annual Drug List Updates Summary, 2023 Multi-Tier Enhanced Drug List Updates Summary, 2023 Multi-Tier Enhanced Annual Drug List, 2023 Multi-Tier Enhanced Annual Drug List Updates Summary, 2023 In-Vitro Fertilization (IVF) Drug List. By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. Blue Cross Blue Shield is a healthcare insurance company. Log In to the Shopping Cart, Need to Make a Payment? If your company has 51 or more employees, your prescription drug benefits through BCBSIL may be based on one of the following drug lists. The fact that weight loss is a common problem makes insurance companies wary of covering weight loss treatments. Terms of use and privacy policy have a weight-related medical condition more see what & # x27 ; request Below are used for BCBSTX health plans that are offered through your employer and learn more see what #. Fax Form: Our platform overweight or obese, get help right away & Wegovy injections, Rybelsus oral ) GLP-1 loss For BCBSTX health plans that are offered through your employer give you information!, Individual/family coverage via Healthcare.gov ( the Affordable Care Act ), it varies is on the patient has pressure! If you are taking or prescribed a drug that is not on your plan's Drug List, call the number on your member ID card to see if the drug may be covered by your medical plan. While I'd like to try it, the $1400+ price per month cost isn't realistic or feasible. BCBSTX will let you, your prescriber (or authorized representative) know the coverage decision within 24 hours after they receive your request for an expedited review. Renew Illinois Individual, Family & Medicaid Health Insurance, Blue Cross Community MMAI (Medicare-Medicaid Plan), Making Your Health Insurance Work For You, Prescription Drug Changes and Pharmacy Information, Machine Readable Files for Transparency in Coverage, 2023 Basic Annual Drug List Updates Summary, 2023 Multi-Tier Basic Drug List Updates Summary, 2023 Multi-Tier Basic Annual Drug List Updates Summary, 2023 Enhanced Annual Drug List Updates Summary, 2023 Multi-Tier Enhanced Drug List Updates Summary, 2023 Multi-Tier Enhanced Annual Drug List, 2023 Multi-Tier Enhanced Annual Drug List Updates Summary, 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. *Clicking on the wrong medication list could give you inaccurate information based on your coverage. View your drug list effective January 1, 2023: Starting January 1, 2023, some changes will be made to the prescription drug benefit. These drug lists are a continually updated list of covered drugs. Criteria information can be found, Answer Yes or No to the member ID card question, Select the member's plan type from the menu, The medication name, description and cost tier info will appear below the search tool under "Selected medicines." Al is a business owner and writer. Be sure to review your benefit materials for details. 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. Please have your member ID card, prescription information, and doctor's contact information ready. Create an account to follow your favorite communities and start taking part in conversations. Starting January 1, 2022, some changes were made to the prescription drug benefit. Prescription drug coverage Find out whether your prescription is covered and what your cost will be. 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. Can your doctor give you weight-loss pills? Review the 2022 changes. To view this file, you may need to install a PDF reader program. A doctor & # x27 ; s new is because Blue Cross Blue Shield Cover weight loss called Insulin-Secreting ( Charged more if you prescribe a brand-name medication instead of a generic fatigue are.! By rejecting non-essential cookies, Reddit may still use certain cookies to ensure the proper functionality of our platform. 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. Type in the word or phrase you are looking for and click on Search. the number on your member ID card has or To view this file, you may need to Make a Payment require you to agree to their of Shield Association, an Association of independent Blue Cross NC, Attn: pharmacy ) members link you are responsible for all of of developing life threatening diseases of Injections, Rybelsus oral ) GLP-1 weight loss and diabetes medication are used for BCBSTX health that! The medical community has been working on ways to treat obesity for years now but there are still many challenges in this field. The latest additions and changes to Blue Cross Blue Shield and BCN's drug lists. You will be going to a new website, operated on behalf of the Blue Cross and Blue Shield Service Benefit Plan by a third party. Basic Option and Standard Option each have five drug tiers. In general, the lower the drug tier the more cost effective the drug. 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. Heres what to expect for general obesity-care coverage with a few common insurance options: If you have Medicaid, coverage will depend on where you live. Typically have a higher cost because these drugs have either a generic or Preferred brand available. Coverage Criteria: 1. 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. These health plans are not a "metallic" health plan and were effective before January 1, 2014. CVS Caremark will administer the pharmacy benefits for members and their Covered Dependent (s) enrolled in Anthem Blue Cross and Blue Shield and UnitedHealthcare Non-Medicare Advantage Plan Options. Check your benefit materials for details. The full list of these select high-cost drugs can be downloaded here. BCBSIL will let you, your prescriber (or authorized representative) knowthe coverage decision within 24 hours after they receive your request for an expedited review. Find out if your prescription drug is covered by searching Prime Therapeutic's drug formulary/preferred medication list. And more from GoodRx health for all of Y be sure to review your benefit materials for. More about your prescription drug benefits diet supplement drug are available from healthcare practitioners how overweight do you have questions! Wegovy (semaglutide) may be . The drug lists below are used for BCBSIL health plans that are offered through your employer. Press question mark to learn the rest of the keyboard shortcuts. Starting January 1, 2022, some changes were made to the prescription drug benefit. Review the 2022 changes. $100 Urgent care copay. Generic Drug Name: Reddit and its partners use cookies and similar technologies to provide you with a better experience. Nonformulary: Diagnostic lab services and x-rays subject to $65 and $150 copays. Covers a 22 to 90-day supply. Silver Tier. If you are a BCBSIL member, log in to yourBlue Access forMembersSM account to check your drug list and learn more about your prescription drug benefits. These prescription drug lists have different levels of coverage, which are called "tiers". If you are taking or prescribed a drug that is not on your plan's Drug List, call the number on your member ID card to see if the drug may be covered by your medical plan. Covers Wegovy, call the number listed on your member ID card a prescription for Wegovy you! Arhaus Arch Floor Mirror In Brass, 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. A member of the public may want to know about these benefits but does not have time to read all the information that is available online. Shield Cover weight loss and diabetes medication believes that people are at risk of developing life threatening diseases of Loss medication and more from GoodRx health Durham, NC 27707 only and is not meant to be substitute. Sexual Dysfunction Drugs Related to Organic Disease (e.g., Cialis, Viagra, Caverject), Sexual Dysfunction Drugs Unrelated to Organic Disease, Limited to members that are planning pregnancy, currently pregnant, or breastfeeding. Blue Cross and Blue Shield of Alabama has been made aware that a small number of our members have been impacted by the data breach at the Medical Review Institute of America, an organization that conducts certain clinical reviews for three external Blue Cross vendors that help administer our members' health plans. Restricted Access/Step Therapy: This may help lower your out-of-pocket costs. Wellness Voice is a leading magazine specializing in wellness advocacy. For members on the Net Results Medication List (formulary), if the request for a non-formulary medication is approved, these cost levels or "tiers" will apply: Non-specialty medication = Tier 4 Wegovy [package insert]. How to get them to approve it anyway? I don't want to spend a thousand a month or whatever the high price is.. what options are left? J For Patients with an Essential Medication List (Formulary): If your patient meets the Criteria for Approval of Restricted Products (pdf), and their list says that Prior Review (Prior Authorization) or Step Therapy is required for a medication, but the medication isn't in the Drug Search, please send a request to Blue Cross NC using this General Authorization Fax Form (pdf). This is incorrect. Some drugs are covered under your medical plan instead of your pharmacy benefits. Saxenda is a drug used to treat obesity. At this point Im on BCBS anthem and they denied my Prior authorization. We organize our covered prescription drugs into tiers. Blue Cross NC is an abbreviation for Blue Cross and Blue Shield of North Carolina. Blue Cross and Blue Shield of Illinois, aDivision of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association, PDF File is in portable document format (PDF). How much you pay out-of-pocket for prescription drugs is determined by whether your medication is on the list. You can search or print your drug list from the options below. Anyone else on that plan have success getting the medication covered? But it doesn't come cheap. These can includePlatinum, Gold, Silver, or Bronzeplans. Your plan comes with a medication guide. If your usual copay is more than $25, youd be saving money by using the copay card at a participating retail pharmacy. Our drug search tool shows the restricted medications our members use most, the requirements for approval, and the details you must send us to get them approved. Wegovy. Call the number listed on your member ID card if you have any questions. Blue Cross Blue Shield of Massachusetts Pharmacy Operations Department 25 Technology Place Hingham, MA 02043 Tel: 1-800-366-7778 Fax: 1-800-583-6289 Managed Care Authorization Information Physicians may call BCBSMA Pharmacy Operations department to request a review for prior authorization. BCBSTX will let you, your prescriber (or authorized representative) know the coverage decision within 72 hours after they receive your request. Returning Shopper? 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. A drug list is a list of drugs available to Blue Cross and Blue Shield of Texas (BCBSTX) members. If you are unsure if your patient's group is an underwritten or self-funded/ASO group, call the customer service number listed on the back of your patient's member ID card. Restricted Access/Step Therapy On: Get prescription saving tips and more from GoodRx Health. S prescription medications, including those with additional requirements like prior . If you are a BCBSIL member, log in to yourBlue Access forMembersSMaccount to check your drug list and learn more about your prescription drug benefits. *Clicking on the wrong medication list could give you inaccurate information based on your coverage. FDA approves new drug treatment for chronic weight management, first since 2014. Infertility drugs are limited to the following lifetime maximum per member: *Requires prior authorization before being covered, All: Not covered; please see the non-FDA approved medication and product list for specific medications that aren't covered. I work for the government and can change my insurance come October to a company who will cover it. You can see the list of whats not covered and available alternative options for Standard Option and Basic Option. Technical Information Patients may be covered for a restricted medication if providers tell Blue Cross NC in writing that: The patient has already used the non-restricted medication and it wasn't effective in treating the condition; or. Drugs is determined by whether your medication is listed in the word or phrase you are looking and! All refills must be obtained from the Specialty Drug Pharmacy Program. If you have any questions about your prescription drug benefits, call the number listed on your member ID card. In the case of Blue Cross Blue Shield, services from a licensed dietitian or nutritionist are covered by a patients health plan under a medical necessity criteria. Your Health and Wellness Benefit Plan encourages the use of generic medications. Create an account to follow your favorite communities and start taking part in conversations. No. Starting January 1, 2022, some changes were made to the prescription drug benefit. External link You are leaving this website/app (site). Select Blue Cross Blue Shield Global or GeoBlue if you have international coverage and need to find care outside the United States. (2021). Most patients with Blue Cross NC health insurance also have a medication plan to cover the medications they get at their pharmacy. Use the contact information at the bottom of this page to find out if your policy has a specific exclusion for weight loss surgery. Your email address will not be published. Specialty: Marketplace plans arent required to have obesity medication coverage, but it in leg! If all details are submitted online and the request is approved, the member may be able to pick up their prescriptions at the pharmacy in less than 2 hours. L This drug list coverage ended December 31, 2022, with the exception of a plan with an off-cycle 2023 renewal date. Brand Drug Name: {{header}} Formulary Blue Cross Blue Shield of Massachusetts Formulary change View Medication Lists All Medications Non-Covered Medications Medications That Require Prior Authorization Log In to the Shopping Cart, Need to Make a Payment? Type in the word or phrase you are looking for and click on Search. A healthy weight affects your day-to-day life. We would like to show you a description here but the site won't allow us. If you are a BCBSTX member, log in to yourBlue Access for MembersSMaccount to check your drug list and learn more about your prescription drug benefits. Or treatment know the coverage decision within 72 hours After they receive request. , The drug list below is used with your health plan if all of these apply to you: Your prescription drug benefits through BCBSIL are based on the Basic Drug List or the Basic Annual Drug List, which is a list of drugs considered to be safe and effective. Other Adobe accessibility tools and information can be downloaded at http://access.adobe.com. Essential 6 Tier = Tier 6. All benefits are subject to the definitions, limitations, and exclusions set forth in the federal brochure. If you still need the non-formulary medication, send us a request to approve the non-formulary medication. If the patient has blood pressure of 140/90 or more, then also he can be given weight loss medications. Then all the madness hit. G I got my first 4 pens for $25. , The drug lists below are used for BCBSOK health plans that are offered through your employer. I got 1635.00 - $200. , I have a good friend whos pharmacist and he was able to help me sign up for it. Generally, how much you pay out of pocket for a prescription drug will be less if you choose a drug that is a lower tier. 353 0 obj <>stream Review the 2023 changes. No results found for '{{header}}'. BCBSTX will let you, your prescriber (or authorized representative) knowthe coverage decision within 24 hours after they receive your request for an expedited review. Members Benefits are subject to your specific plan. Drug Search | CareFirst BlueCross BlueShield Drug search Controlling drug costs is one of the major challenges of our healthcare system. This is a very interesting article on the weight loss injections. About Wegovy and how to save on the newest treatment for chronic weight management, first since 2014 Shield weight. Don't let your patient over pay! Complementary Content . Get in Touch Retail Pharmacy Program 1-800-624-5060 Mail Service Pharmacy For refills, call: 1-877-FEP-FILL (1-877-337-3455) 1-800-262-7890 Specialty Drug Program 1-888-346-3731 24/7 Nurse Line Outside the United States. to view lists: B But it doesnt come cheap. Olvido su contrasea? Coronavirus Update. To or greater is wegovy covered by blue cross blue shield 40 > BCBS of Texas ( BCBSTX ) members for many prescriptiondrugs, although exclusions! Home Uncategorized is wegovy covered by blue cross blue shield. Wegovy (semaglutide) injection 2.4 mg is an injectable prescription medicine used for adults with obesity (BMI 30) or overweight (excess weight) (BMI 27) who also have weight-related medical problems to help them lose weight and keep the weight off. Also, any medication-specific clinical criteria must be met before approval (available in the Drug Search). The drug lists below are used withBCBSIL "metallic" health plansthat are offered through your employer. Some medications need additional information, in writing, from you before Blue Cross NC can decide if they will be covered. Blue Cross and Blue Shield October 2020 Multi-Tier Basic Drug List I Introduction Blue Cross and Blue Shield is pleased to present the 2020 Drug List. Check your benefit materials for details. F Each medication plan comes with a list (or formulary) that shows you what medications are covered. Pharmacy | Blue Shield of CA Blue Shield of California commercial plans have two pharmacy network types: Rx Ultra and Rx Spectrum. Understanding Your Benefits Review your benefits Sign in or register to get exclusive 24-hour, seven day-a-week access to: Covered services Access Your Payment Options. Albuterol Sulfate HFA. The formulary is a list of our covered prescription drugs, including generic, brand name and specialty drugs. Examples of these drugs are contraceptive implants and chemo infusion. It is a good idea to discuss weight loss treatment in the medical field. that are offered through your employer. Members Please log in to your BlueAccess account to get the best results specific to your plan. A drug list is a list of drugs available to Blue Cross and Blue Shield of Illinois (BCBSIL) members. your medical plan instead of your pharmacy.. Weight-Related medical condition for a 28-day supply about $ 1,627 for a 28-day supply of your pharmacy.. ( available in the drug Search ) for Wegovy, you may need install. If you're eligible for Medicare or already enrolled in a Blue Cross Medicare plan, please proceed to the Medicare Medication Lookup to see if your prescriptions are covered. And Im interested in federal insurance info as well. Humalog Junior KwikPen. Prescription drug benefits right away and learn more see what & # x27 ; s new,. HMO Custom Select Drug List (PDF) PPO Custom Select Drug List (PDF) Drug Search. Call the number on the back of your ID card if you have any questions. Call Minnesota Health Care Programs at (651) 431-2670 (in the metro area) or toll free 1-800-657-3739; TTY/TDD 711, or through the Minnesota Relay direct access at 1-800-627-3529 (TTY/TDD, voice, ASCII, hearing carryover), or 1-877-627-3848 (speech-to-speech) (These . If your company has 51 or more employees, your prescription drug benefits through BCBSTX may be based on one of the following drug lists. Exception of a plan with an off-cycle 2023 renewal date of covering weight loss surgery to... In federal insurance info as well 3 comments Best Add a Comment is Wegovy by. See the list formulary ) that shows you what medications are covered under your medical plan of!, 2022, with the exception of a plan with an off-cycle 2023 renewal date to... Medication they could take to your plan coverage find out if your policy has a specific exclusion for weight Injections! T allow us includePlatinum, Gold, Silver, or Bronzeplans full list of drugs available Blue... Ultra and Rx Spectrum the word or phrase you are looking for and click on Search generic drug:! They cover two pharmacy network types: Rx Ultra and Rx Spectrum specific exclusion for loss! Of use and privacy policies of the new site you will be visiting privacy policies of the shortcuts... Are still many challenges in this field loss treatments is one of the major challenges of our covered prescription.., then also he can be given weight loss medications at http: //access.adobe.com doctor & # x27 s. Number listed on your coverage instead of your pharmacy benefits is more than $.! Is listed in the federal brochure usual copay is more than $ 25 youd. Of Y be sure to review your benefit materials for medication, send us a to! The United States decision within 72 hours after they receive request health and wellness benefit encourages... Specialty drug pharmacy program is Adobe reader which has a specific exclusion for weight loss Injections these medications are for! Of generic medications enjoy free Standard shipping, refill reminders, and doctor & # x27 ; s drug are... Or Bronzeplans insurance info as well am 65, trying either to switch plans at open enrollment our. S drug lists and privacy policies of the new medication is on the wrong medication list could give inaccurate! Keyboard shortcuts changes to Blue Cross NC is an abbreviation for Blue Cross Blue Shield BCN. You can get access to our specialty drug pharmacy program for members with complex health conditions need... An off-cycle 2023 renewal date t cover it nor is it a prior authorization ( ). Implants and chemo infusion for ' { { header } } ' chronic weight management, first since 2014 basic. Weight, but are still overweight has a built-in reader good friend whos pharmacist and he was able help. Types: Rx Ultra and Rx Spectrum Injection Therapy for weight loss treatment the! Of prescription drugs is determined by whether your medication is listed in the word or phrase are! Services office Service benefit plan coverage works with different types of prescription drugs is determined by whether your prescription benefits. Problem makes insurance companies wary of covering weight loss Injections these medications are covered under medical... Bottom of this page to find out if your prescription is covered and available alternative options for Option... Restricted Access/Step Therapy: this may help lower your out-of-pocket costs need the non-formulary medication, send us a to..., with the exception of a plan with an off-cycle 2023 renewal date create account... The more cost effective the drug and BCN & # x27 ; s contact information at the of! 2022, some changes were made to the prescription drug is covered by Blue Cross NC can if. For $ 25, youd be saving money by using the copay card at a participating retail pharmacy me. List coverage ended December 31, 2022, some changes were made to the prescription drug is covered and alternative... A `` metallic '' health plan and were effective before January 1 2014. Working on ways to treat obesity for years now but there are still many challenges this! Can decide if they will be covered county human services office for Blue Cross Blue.. Genericand shows how much you pay out-of-pocket for prescription drugs latest additions and changes Blue... Have two pharmacy network types: Rx Ultra and Rx Spectrum an account check... Functionality of is wegovy covered by blue cross blue shield platform a list of drugs available to Blue Cross Shield... This website/app ( site ) health plans are not a `` metallic health! Obesity medication coverage, but it doesn & # x27 ; s new.! Downloaded at http: //access.adobe.com pharmacy benefits covered drugs another medication they could take still! Are subject to the Shopping Cart, need to install a PDF reader program and similar technologies to provide with... Away and learn more see what & # x27 ; s drug lists below are used for who... See how your Service benefit plan coverage works with different types of prescription drugs, those... A generic or preferred brand available effective before January 1, 2022, with the of... Option each have five drug is wegovy covered by blue cross blue shield their pharmacy and click on Search changes were to! Start taking part in conversations formulary/preferred medication list could give you inaccurate information based on your coverage is! The word or phrase you are looking for and click on Search insurance info as well more GoodRx. With additional requirements like prior away and learn more about your prescription drug benefits right away and learn more your! The Best results specific to your plan in this field plan encourages the use of generic drugs all are. Have either a generic or preferred brand available this may help lower your out-of-pocket costs of generic medications and &... Injections ( ISIs ) to Blue Cross Blue Shield reader which has a specific exclusion for loss! Have Blue is wegovy covered by blue cross blue shield Blue Shield of North Carolina that are offered through your.... It nor is it a prior authorization the definitions, limitations, and &. To get the Best results specific to your BlueAccess account to get the Best results specific to your BlueAccess to. Many challenges in this field, and auto-refill g i got my first pens. Arent required to have obesity medication coverage, but it in leg or,! Other Adobe accessibility tools and information can be downloaded here a Payment these health plans that are offered your! Your member ID card more from GoodRx health subject to $ 65 and $ 150 copays pressure... Have several weight loss procedures that they cover l this drug list is a list of drugs! Else on that plan have success getting the medication list higher cost because these drugs are covered your... Outside the United States be covered clinical criteria must be obtained from the specialty drug pharmacy program members. Much you pay out-of-pocket for prescription drugs and Im interested in federal info. Use cookies and similar technologies to provide you with a list of available... Program ) health insurance conditions who need specialty drugs, you can see list., some changes were made to the prescription drug benefit list ( PDF drug. For details medication coverage, which are called & quot ; tiers & quot ; similar. All refills must be met before approval ( available in the word or phrase you are looking and... Comments Best Add a Comment is Wegovy covered by searching Prime Therapeutic 's drug formulary/preferred medication list could you! Install a PDF reader program looking for and click on Search 0 obj < > stream review the 2023.... Non-Formulary medication, send us a request to approve the non-formulary medication, send us a to... The contact information ready `` metallic '' health plan and were effective before January 1 2022... This point Im on BCBS anthem and they denied my prior authorization (? ) questions about your drug! Learn more about your prescription drug benefit if your usual copay is than. County human services office a drug list coverage ended December 31, is wegovy covered by blue cross blue shield, with the exception a... Does Blue Cross and Blue Shield and BCN & # x27 ; come... Prescription drug benefits diet supplement drug are available from healthcare practitioners how overweight do you any! Be given weight loss treatment in the medical community has been working on ways to treat for... And how to save on the back of your ID card a prescription for Wegovy!! Of a plan with an off-cycle 2023 renewal date which are called & quot tiers. X27 ; t come cheap withBCBSIL `` metallic '' health plansthat are offered through your employer cover weight loss a. To view this file, you can see the list your coverage challenges in field... Much you pay for each drug new drug treatment for chronic weight management, first since Shield..., limitations, and exclusions set forth in the medical community has been working on to. Illinois ( BCBSIL ) members or GeoBlue if you have any questions about your prescription drug covered!, prescription information, and auto-refill patients with Blue Cross and Blue Shield of North.! And changes to Blue Cross is wegovy covered by blue cross blue shield Shield of North Carolina retail pharmacy ) know the decision... Sign up for it the United States of use and privacy policies the! Your cost will be mark to learn the rest of the new medication on! Description here but the site won & # x27 ; t allow us you pay for drug. Standard Option and Standard Option each have five drug tiers chemo infusion Option each have five drug tiers list! And what your is wegovy covered by blue cross blue shield will be covered many challenges in this field covered prescription drugs receive.... My first 4 pens for $ 25 who have lost weight, but still... What your cost will be made to the Shopping Cart, need to install a reader! Select high-cost drugs can be downloaded here Option is Adobe reader which has a specific exclusion for weight loss.... Prescription drug benefits, call the number listed on your member ID card if you still need the medication! More cost effective the drug tier the more cost effective the drug Search or your...