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Formulary changes

The chart below indicates current and future changes to the formulary used by Blue Medicare HMO, Blue Medicare PPO and Blue Medicare Rx. These changes may include the removal of a drug from the formulary or a change in copayment or coinsurance level. Changes will be posted 60 days before a change takes place and will remain displayed until the revised formulary is published on an annual basis.

Blue Medicare Rx Standard

Drug Name Change Type Reason for Change Alternative Options Estimated Cost of Alternative

No changes to reports at this time.
For the most up to date formulary information please use our drug search.

Blue Medicare HMO/PPO and Blue Medicare Rx Enhanced

Drug Name Change Type Reason for Change Alternative Options Estimated Cost of Alternative

No changes to reports at this time.
For the most up to date formulary information please use our drug search.

Important Legal Information and Disclaimers

The information on this page is current as of 10/01/13.

Y0079_6246 CMS Approved 10222013

®, SM Mark of the Blue Cross and Blue Shield Association. SM1 Mark of Blue Cross and Blue Shield of North Carolina.