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Changes to the Blue Medicare Rx Standard Plan Formulary for 2014

In 2014, BCBSNC will be changing the formulary offered on the Blue Medicare Rx Standard plan to a new low-cost formulary. This plan is similar in design to many other low-cost plans that are on the market today. 

Listed below are some of the features of this low-cost prescription drug plan:

  • Significantly fewer drugs will be on this formulary as compared to the 2013 formulary.
  • Many generic products are on this formulary, but there is less coverage of brand-name drugs.
  • Drugs with safety concerns removed. For instance, combination drugs with more than 325mg of acetaminophen (e.g. hydrocodone 5mg/acetaminophen 500mg). 
  • Drugs considered high risk when taken by older patients were removed or placed in the non-preferred brand tier, regardless of product type, and may have  prior authorization requirements.
  • Only generic drugs with low drug costs were included on tier 1*.
  • Extremely high-cost generics (>$300/script) or drugs with safety concerns were moved to non-preferred brand tier 4.

BCBSNC will be contacting the members on this plan who are impacted by the formulary changes by letter and by phone.

Additional communication about these formulary change will be included in the Annual Notice of Change . Our normal transition process will be applied at the beginning of the year for coverage of medications until the member can discuss other medication options with their provider. 

*In 2014: Tier 1= Preferred Generic Drugs, Tier 2= Nonpreferred Generic Drugs, Tier3 = Preferred Brand-Name Drugs, Tier 4= Nonpreferred Brand-Name Drugs, and Tier 5= Specialty Drugs