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Covered Drug List

Covered Drug List

When your employees have coverage with BlueChoice HealthPlan, they have access to a wide variety of prescription drugs. Our Covered Drug List gives your employees and their doctor choices. They must choose drugs on this list to have them covered under your company's benefit plan. How much your employees pay for drugs depends on which plan your company has. There are also certain drugs that have extra requirements before your employees have coverage.

Search our Covered Drug List to see what prescription drugs we cover. 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. 

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 company's 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.

Our goal is to give your employees a choice of safe and effective drugs, while also keeping drug costs affordable. With more than 68,000 network pharmacies to choose from, it's easy to find one that's near with our Pharmacy Locator. View a brief list of all national retail chains and some independent pharmacies in South Carolina. Also view a comprehensive list of South Carolina pharmacies. 

Save money with generics! Learn more about generic drugs and additional prescription drug information in our FAQs.

Vaccines

Where can you get your flu vaccine and other vaccines?

Effective immediately, your employees can get your seasonal flu vaccine covered at $0 copay through our pharmacy benefit by visiting a CVS pharmacy. Find a participating CVS pharmacy within South Carolina or the entire U.S. Or, your employees can visit their primary care physician. If they don't have one, they can find one here

Your employees can also visit a participating CVS pharmacy within South Carolina or the entire U.S. to get some non-seasonal preventive care vaccines at a $0 copay. Below is a chart of these vaccines:

  Adults Children (birth to age 18) 
Pneumonia  X X
Hepatitis A X X
Hepatitis B X X
Human Papillomavirus X X
Varicella X X
Measles, Mumps, Rubella X X
Meningococcal X X
Tetanus X X
Tetanus, Diphtheria, Pertussis X X
Measles, Mumps, Rubella, Varicella   X
Tetanus, Diphtheria   X
Inactivated Poliovirus   X
Zoster  X  
Tetanus, Diphtheria, Toxoids  X  
Hepatitis A & B  X  

*This vaccine is only covered for those ages 50 and older.