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Blue Choice

Covered Drug List

A Covered Drug List is a list of prescription drugs a group of network doctors and pharmacists who advise us on pharmacy issues approves. They choose these drugs because they are safe and effective, as well as cost effective. The Covered Drug List has six coverage levels, called tiers. Print a 2017 copy of our drug list.

Tier 0 –These drugs are considered preventive medications under the Affordable Care Act, and we cover them at no cost to you. 

Tier 1 – Drugs on this tier are usually preferred generic drugs. They will typically cost the least amount of money out of your pocket.

Tier 2 – Drugs on this tier are usually generic drugs. They will typically cost less than brand drugs.

Tier 3 – Drugs on this tier are usually preferred brand drugs. They typically cost less than other brand drugs.

Tier 4 – Drugs on this tier are usually non-preferred brand drugs. They typically cost more than other brand drugs and may have generic equivalents.

Tier 5 – Drugs on this tier are usually preferred specialty drugs that are used to treat complex conditions. They are typically very expensive. 

Tier 6 – Drugs on this tier are usually specialty drugs that are used to treat complex conditions. They are typically the most expensive drugs available. 

Certain drug categories, such as weight loss and erectile dysfunction drugs, are excluded from coverage. Please see your plan materials for a complete list of these exclusions.

The Covered Drug List may change during the year. A common example is that when a new generic becomes available for a preferred brand drug, we remove the brand-name drug.