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Looking for an individual plan?

Find a drug

To search for a generic or brand name drug, select the first letter of the drug from letters above the chart below. The index will display all the drugs beginning with that letter in alphabetical order, so that you can scan the list for your drug.

You can also download and print your plan's drug list by selecting the appropriate link:

Blue Medicare HMO / Blue Medicare PPO Opens in new window
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Table legend
'Tier' refers to the level of coverage for each medication. The tier levels are the following:

1 Tier 1 medications are generic medications and have the lowest copayment.
2 Tier 2 medications are brand name medications and have the second-lowest copayment.
3 Tier 3 medications are medications classified by BCBSNC as specialty drugs. Tier 3 medications are typically prescribed by a specialist, have unique uses, and may require special dosing administration. Tier 3 medications generally cost more than other drugs, and members must pay a coinsurance amount for them.

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
Drug name Tier Generic equivalent Notes
ABELCET 3 n/a

Prior authorization required

ABILIFY 2 n/a  
ABILIFY DISCMELT 2 n/a  
ABRAXANE 3 n/a  
ACCOLATE 2 n/a  
ACCUNEB 2 albuterol sulfate

Prior authorization required

Generic substitution allowed
ACCUPRIL 2 quinapril hcl Generic substitution allowed
ACCURETIC 2 quinapril/­hydrochlor Generic substitution allowed
ACCUTANE 3 isotretinoin Generic substitution allowed
acebutolol hcl 1 n/a  
ACEON 2 n/a  
ACETADOTE 2 n/a

Prior authorization required

acetaminophen w/­codeine 1 n/a  
acetazolamide 1 n/a  
acetazolamide sodium 1 n/a  
acetic acid 1 n/a  
acetic acid/­hydrocortisone 1 n/a  
acetylcysteine 1 n/a

Prior authorization required

ACIPHEX 2 n/a  
ACLOVATE 2 alclometasone diprop Generic substitution allowed
ACTHIB 2 n/a  
acticin 1 n/a  
ACTIGALL 2 ursodiol Generic substitution allowed
ACTIMMUNE 3 n/a  
ACTIQ 3 n/a  
ACTIVELLA 2 n/a  
ACTONEL 2 n/a  
ACTONEL WITH CALCIUM 2 n/a  
ACTOPLUS MET 2 n/a  
ACTOS 2 n/a  
ACULAR 2 n/a  
ACULAR LS 2 n/a  
ACULAR PF 2 n/a  
acyclovir 1 n/a  
acyclovir sodium 1 n/a

Prior authorization required

ADACEL 2 n/a  
ADAGEN 3 n/a  
ADALAT CC 2 nifedipine Generic substitution allowed
ADDERALL 2 amphet asp/­amphet/­d- Generic substitution allowed
ADDERALL XR 2 n/a  
ADOXA 2 doxycycline monohydr Generic substitution allowed
ADOXA PAK 2 doxycycline monohydr Generic substitution allowed
adrenalin chloride 1mg/­ml vial 1 n/a  
ADRENALIN CHLORIDE SOL, NON-ORAL 2 n/a

Prior authorization required

adriamycin 10mg vial 1 n/a

Prior authorization required

ADRIAMYCIN 20MG VIAL 2 n/a

Prior authorization required

adriamycin 2mg/­ml 1 n/a

Prior authorization required

adriamycin 50 mg vial 1 n/a

Prior authorization required

ADVAIR DISKUS 2 n/a  
ADVAIR HFA 2 n/a  
ADVICOR 2 n/a  
AEROBID 2 n/a  
AEROBID-M 2 n/a  
afeditab cr 1 n/a  
AGENERASE 2 n/a  
AGGRENOX 2 n/a  
AGRYLIN 3 anagrelide hcl Generic substitution allowed
a-hydrocort 1 n/a  
AIRET 2 albuterol sulfate

Prior authorization required

Generic substitution allowed
ak-con 1 n/a  
AKINETON 2 n/a  
AKNE-MYCIN 2 n/a  
ak-poly-bac 1 n/a  
aktob 1 n/a  
ala-cort 1 n/a  
ALAMAST 2 n/a  
ALA-SCALP HP 2 n/a  
ALBALON 2 naphazoline hcl Generic substitution allowed
ALBENZA 2 n/a  
albuterol aerosol 1 n/a  
albuterol sulfate er tab 1 n/a  
albuterol sulfate sol 1 n/a

Prior authorization required

albuterol sulfate syrup 1 n/a  
albuterol sulfate tab 1 n/a  
ALCAINE 2 proparacaine hcl Generic substitution allowed
alclometasone dipropionate 1 n/a  
alcohol in dextrose 1 n/a

Prior authorization required

ALCOHOL PREP 2 n/a  
ALDACTAZIDE 25-25MG 2 spironolact/­hydrochl Generic substitution allowed
ALDACTAZIDE 50-50MG 2 n/a  
ALDACTONE 2 spironolactone Generic substitution allowed
ALDARA 2 n/a  
ALDURAZYME 3 n/a  
alendronate sodium tab 1 n/a  
ALESSE 2 levonorgestrel-eth e Generic substitution allowed
ALFERON N 3 n/a  
ALIMTA 3 n/a  
ALINIA 2 n/a  
ALKERAN VIAL 3 n/a

Prior authorization required

ALLEGRA SUSP 2 n/a  
ALLEGRA TAB 2 fexofenadine hcl Generic substitution allowed
ALLEGRA-D 2 n/a  
allopurinol 1 n/a  
ALLOPURINOL SODIUM 2 n/a  
ALOCRIL 2 n/a  
ALOMIDE 2 n/a  
ALOPRIM 2 n/a  
ALORA 2 n/a  
ALOXI 2 n/a  
ALPHAGAN P 2 n/a  
alphatrex 1 n/a  
ALREX 2 n/a  
ALTABAX 2 n/a  
ALTACE CAP 2 ramipril Generic substitution allowed
ALTOPREV 2 n/a  
ALUPENT 2 n/a  
amantadine hcl 1 n/a  
AMARYL 2 glimepiride Generic substitution allowed
AMBIEN 2 zolpidem tartrate Generic substitution allowed
AMBIEN CR 2 n/a  
AMBISOME 3 n/a

Prior authorization required

amcinonide 1 n/a  
AMERGE 2 n/a

Quantity limitations apply

a-methapred 1 n/a  
AMEVIVE 3 n/a  
amikacin sulfate 1 n/a  
amikin 1 n/a  
AMIKIN PEDIATRIC 2 amikacin sulfate Generic substitution allowed
amiloride hcl 1 n/a  
amiloride hcl w/­hctz 1 n/a  
aminophylline 1 n/a  
AMINOSYN 10% 2 n/a

Prior authorization required

AMINOSYN 3.5% 2 n/a

Prior authorization required

AMINOSYN 5% 2 n/a

Prior authorization required

AMINOSYN 7% 2 n/a

Prior authorization required

AMINOSYN 8.5% 2 n/a

Prior authorization required

AMINOSYN II 10% 2 n/a

Prior authorization required

aminosyn ii 15% 1 n/a

Prior authorization required

AMINOSYN II 3.5% M/­DEXTROSE 5% 2 n/a

Prior authorization required

AMINOSYN II 3.5%/­DEXTROSE 25% 2 n/a

Prior authorization required

AMINOSYN II 3.5%/­DEXTROSE 5% 2 n/a

Prior authorization required

aminosyn ii 4.25% m/­dext 10% 1 n/a

Prior authorization required

aminosyn ii 4.25%/­dextrose 25% 1 n/a

Prior authorization required

AMINOSYN II 5% IN 25% DEXTROSE 2 n/a

Prior authorization required

AMINOSYN II 7% 2 n/a

Prior authorization required

AMINOSYN II 8.5% 2 n/a

Prior authorization required

AMINOSYN II IN DEXTROSE 4.25% 2 n/a

Prior authorization required

AMINOSYN II W/­ELEC IN DEX W/­CA 3.5% 2 n/a

Prior authorization required

AMINOSYN II W/­ELEC IN DEX W/­CA 4.25% 2 n/a

Prior authorization required

AMINOSYN M 3.5% 2 n/a

Prior authorization required

AMINOSYN W/­ELECTROLYTES 7% 2 n/a

Prior authorization required

AMINOSYN-HF 8% 2 n/a

Prior authorization required

amiodarone hcl 1 n/a  
AMITIZA 2 n/a  
amitriptyline hcl 1 n/a  
amitriptyline w/­perphenazine 1 n/a  
amitriptyline w/­perphenazine 1 n/a  
amitriptyline/­chlordiazepoxide 1 n/a  
amlodipine besylate 1 n/a  
amlodipine besylate-benazepril 1 n/a  
AMMONIUM CHLORIDE 2 n/a  
ammonium lactate 1 n/a  
amnesteem 1 n/a  
amoclan 1 n/a  
amox tr/­potassium clavulanate 1 n/a  
amoxapine 100mg 1 n/a  
amoxapine 150mg 1 n/a  
AMOXAPINE 25MG 2 n/a  
amoxapine 50mg 1 n/a  
amoxicillin 1 n/a  
AMOXIL 200MG/­5ML 2 amoxicillin trihydra Generic substitution allowed
amoxil 250mg/­5ml 1 n/a  
AMOXIL 400MG/­5ML 2 amoxicillin trihydra Generic substitution allowed
amoxil cap 1 n/a  
AMOXIL CHEW TAB 2 amoxicillin trihydra Generic substitution allowed
amoxil drops 1 n/a  
AMOXIL TAB 2 amoxicillin trihydra Generic substitution allowed
amphetamine salt combo 1 n/a  
amphocin 1 n/a

Prior authorization required

AMPHOTEC 3 n/a

Prior authorization required

amphotericin b 1 n/a

Prior authorization required

ampicillin sodium 1 g vial 1 n/a  
ampicillin sodium 10g vial 1 n/a  
AMPICILLIN SODIUM 125MG VIAL 2 n/a  
ampicillin sodium 250mg vial 1 n/a  
ampicillin sodium 2g vial 1 n/a  
ampicillin sodium 500mg vial 1 n/a  
ampicillin trihydrate 1 n/a  
ampicillin/­sulbactam 1 n/a  
AMRIX 2 n/a  
ANADROL-50 3 n/a  
ANAFRANIL 2 clomipramine hcl Generic substitution allowed
anagrelide hydrochloride 1 n/a  
ANAPROX 2 naproxen sodium Generic substitution allowed
ANAPROX DS 2 naproxen sodium Generic substitution allowed
ANCOBON 2 n/a  
ANDRODERM 2 n/a  
ANDROGEL 2 n/a  
ANDROID 2 n/a  
androxy 1 n/a  
ANEXSIA 2 hydrocodone bit/­acet Generic substitution allowed
ANGELIQ 2 n/a  
ANSAID 2 flurbiprofen Generic substitution allowed
ANTABUSE 2 n/a  
ANTARA 2 n/a  
antibiotic ear solution 1 n/a  
antibiotic ear suspension 1 n/a  
ANTIVERT 2 meclizine hcl Generic substitution allowed
ANTIZOL 3 n/a  
ANUSOL-HC 2 hydrocortisone Generic substitution allowed
ANZEMET 2 n/a

Prior authorization required

ANZEMET VIAL 2 n/a  
APHTHASOL 2 n/a  
APIDRA 2 n/a  
APOKYN 2 n/a  
apri 1 n/a  
APTIVUS 3 n/a  
ARALAST 3 n/a  
ARALEN PHOSPHATE 2 chloroquine phosphat Generic substitution allowed
aranelle 1 n/a  
ARANESP 100MCG 3 n/a

Prior authorization required

ARANESP 150MCG 3 n/a

Prior authorization required

ARANESP 200MCG 3 n/a

Prior authorization required

ARANESP 25MCG 2 n/a

Prior authorization required

ARANESP 300MCG 3 n/a

Prior authorization required

ARANESP 40MCG 3 n/a

Prior authorization required

ARANESP 500MCG 3 n/a

Prior authorization required

ARANESP 60MCG 3 n/a

Prior authorization required

ARAVA 2 leflunomide Generic substitution allowed
AREDIA 3 n/a

Prior authorization required

ARESTIN 2 n/a  
ARICEPT 2 n/a  
ARICEPT ODT 2 n/a  
ARIMIDEX 2 n/a  
ARISTOSPAN 2 n/a  
ARIXTRA 3 n/a  
AROMASIN 2 n/a  
ARRANON 3 n/a  
ARTHROTEC 2 n/a  
ASACOL 2 n/a  
ascomp w/­codeine 1 n/a  
ASMANEX 2 n/a  
aspirin w/­codeine 1 n/a  
ASTELIN 2 n/a  
ASTRAMORPH-PF 2 morphine sulfate/­pf

Prior authorization required

Generic substitution allowed
ATACAND 2 n/a  
ATACAND HCT 2 n/a  
atenolol 1 n/a  
atenolol w/­chlorthalidone 1 n/a  
ATGAM 3 n/a

Prior authorization required