Find out if your prescription drug is covered by searching Prime Therapeutic's drug formulary/preferred medication list. Members – Benefits are subject to your specific plan. To get the best results, specific to your coverage, log in to your BlueAccess® account
and click on Rx Drugs. If you do not have a BlueAccess account, sign up today. Shoppers – If you are not currently covered by Blue Cross and Blue Shield of Kansas (BCBSKS), and are shopping either through HealthCare.gov or through the BCBSKS website for an individual or family plan, you will need to select the 2022 BCBSKS BlueCare/EPO Medication List. *Clicking on the wrong medication list could give you inaccurate information based on your coverage. It is important that you check your coverage before searching to see if a specific drug is covered on your plan. Helping you understand your prescription costsThe formulary is a list of our covered prescription drugs, including generic, brand name and specialty drugs. See how we help keep your out-of-pocket costs low for the medications you and your family need. Tier 1 Preferred Generic DrugsTypically the most affordable drug type, and are equal to their brand name counterparts in quality, performance characteristics and intended use. Tier 2 Preferred Brand Name Drugs Preferred Generic Specialty Drugs Preferred Brand Name Specialty DrugsPreferred brand name: Proven to be safe, effective, and favorably priced compared to Non-preferred brands. Specialty: Used to treat complex health conditions. Proven to be safe, effective, and favorably priced compared to Non-preferred specialty drugs. Tier 1: Generic Drugs
Tier 2: Preferred Brand Name DrugsProven to be safe, effective, and favorably priced compared to Non-preferred brands. Cheaper than Non-preferred brands but more expensive than generics. Tier 3: Non-preferred Brand Name DrugsProven to be safe and effective. Typically have a higher cost because these drugs have either a generic or Preferred brand available. Tier 4: Preferred Specialty DrugsUsed to treat complex health conditions. Proven to be safe, effective, and favorably priced compared to Non-preferred specialty drugs. Tier 5: Non-preferred Specialty DrugsTypically have a higher cost because these drugs have a Preferred specialty available.
This is a summary of the features of the Blue Cross and Blue Shield Service Benefit Plan. Before making a final decision, please read the Plan’s Federal brochures (Standard Option and Basic Option: RI 71-005; FEP Blue Focus: 71-017). All benefits are subject to the definitions, limitations, and exclusions set forth in the federal brochure.
This is a summary of the features of the Blue Cross and Blue Shield Service Benefit Plan. Before making a final decision, please read the Plan’s federal brochures (RI 71-005 and RI 71-017). All benefits are subject to the definitions, limitations, and exclusions set forth in the federal brochure.
Some prescription drugs and supplies need prior approvalTo give prior approval, we need to confirm two things: that you’re using the drug to treat something we cover and that your health care provider prescribes it in a medically appropriate way. Your health care provider can request prior approval electronically, by fax or by mail. The full list of drugs that need to be approved, prior approval forms and additional information can be downloaded here.
Covered equivalents for drugs not on our formularyOur three plan options have certain drugs that are not covered on their formularies. Each non-covered drug has safe and effective, alternative covered drug options. You can see the list of what’s not covered and available alternative options for Standard Option and Basic Option. FEP Blue Focus members can apply for coverage of a drug not covered on their formulary with the Non-Formulary Exception Process (NFE) form. How do I get free Saxenda?Ask the prescriber about patient assistance. For high-priced, long-term medications like Saxenda, often the best option is to take advantage of a manufacturer's patient assistance program. People who meet the eligibility requirements could receive their entire prescription for free from Novo Nordisk, the manufacturer.
What tier is Saxenda?Saxenda is covered on the OptumRx Select and Premium Formularies at Tier 3 with Prior Authorization. Medications may move to a lower tier throughout the year, helping members take immediate advantage of cost savings.
How much is Saxenda at Walgreens?Although liraglutide also treats Type 2 diabetes under a different brand name, Saxenda is used to promote weight loss in certain patients.
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Average 12 Month Prices for Saxenda.. Is Saxenda available on the medical card?Saxenda® is currently been assessed under the national processes for pricing and reimbursement and therefore is not available under any of the Community Drugs Schemes including Discretionary Hardship Arrangements until that process is completed with a positive decision by the HSE.
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Saxenda covered by blue cross blue shield
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