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INDIVIDUAL & FAMILY

2024 Prescription Drug Changes

Check if any of these changes may impact you. You can also learn how to get the most of your pharmacy benefits. Be sure to check this page often for any changes to your drug list.

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Man at a pharmacy speaking with a pharmacist.

Prescription Changes

Understand How Your Prescription Drugs May Change

Starting January 1, 2024, some prescription drugs:

  • May move to a higher or lower drug tier
  • May be added to or removed from the drug list
  • May have new special requirements 

Your 2024 Drug Lists

Depending on your plan, you will either have a 6 Tier Drug List or a 4 Tier Drug List . The 2024 drug lists are for coverage that renews or starts on or after January 1, 2024

Please note that some drugs may be covered under your health plan’s medical benefits instead of your pharmacy benefits.2

  • Medical benefits: drugs covered under your medical benefits must be given to you by a health care professional in a hospital, office or health care setting.
  • Pharmacy benefits: drugs covered under your pharmacy benefits are prescribed medicines you can take on your own.

If you are taking or prescribed a drug not on your plan’s drug list, call the number on your member ID card to learn if the drug could be covered by your plan’s medical benefits.

 
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Additional Requirements

Your Prescriptions May Require a Few Extra Steps

When reviewing your drug list, you might find letters in the additional requirements columns. Here's what they mean:

  • PA (prior authorization) – A medicine may need to be pre-approved before it can be covered by your plan.
  • ST (step therapy) – You may need to try a more cost-effective drug first before other drugs may be covered.
  • QL (dispensing or quantity limits) – You may only be able to get a certain amount of your drug at one time.

Talk with your doctor if your drug has an additional requirement.

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UNDERSTANDING TIERS

How Prescription Tiers Work

Your health plan’s prescription drug list has a few levels of coverage, called member payment tiers.

Depending on your plan, you’ll have 4 tiers or 6 tiers. Each tier has its own cost with lower tiers normally costing less. You can find your medicine's drug tier when you check the drug list.

SAVINGS

Ways To Save On Your Prescription

Prescriptions can be expensive. You may be able to save on your drug or pharmacy costs. As always, check with your doctor to learn if these options may work for you.

Search In-Network Pharmacies
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Use in-network pharmacies

Your out-of-pocket costs are often lower at an in-network pharmacy. 

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Ask about lower-cost options

You may have lower-cost alternatives, like generic drug options, if your drug moves to a higher tier.

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Visit a value pharmacy

Value pharmacies often have the highest savings and often offer 90-day drug supplies and home delivery.

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Use drug coupons

Drug manufacturer’s coupons or copay cards can help you lower your prescription's cost at check-out.3

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NEXT STEPS

Take These Steps With Your Doctor or Pharmacist

Talk with your doctor about your next steps. Your doctor or pharmacist can answer questions or concerns you may have about your prescribed medications.  Pharmacy selections and your care are always between you and your doctor.

  • Lower Cost Alternatives Ask about lower-cost alternatives if your drug moves to a higher tier.
  • Drug Options Review other options if your drug is no longer covered (often a covered generic or brand alternative may be available).
  • Prescription Updates Have an authorization request sent to us, or change your prescription, if your drug has an additional requirement.
  • Stay In-Network Order your prescriptions to be filled at in-network pharmacies.

Member Account

Review Your Pharmacy Benefits

Visit Blue Access for Members℠ to find in-network pharmacies, check your Rx benefits and more.

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