Drug List
The drug list, also called a formulary, includes both brand name and generic drugs. Generics have the same active ingredient formula as a brand name drug. Generic Drugs usually cost less than brand name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand name drugs.
As you review the drug list for your prescriptions, keep in mind:
- The drug list is the same no matter which Blue MedicareRxSM plan you enroll in
- To receive benefits, Blue MedicareRx network pharmacies or our mail-order service, PrimeMail, must be used (except in an emergency)
- Using PrimeMail or our preferred network pharmacies offers you the ability to purchase a 90-day supply of a prescription drug and pay only two and a half months of copays instead of three*
Limitations, copayments, and restrictions may apply.
Search the Drug List
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Download a copy of the drug list 
S5715_MRK_TMP_FRMLRY12a File and Use 10012011
Drug list en Español
S5715_MRK_TMP_FRMLRY12aSPA File and Use 10012011
Blue MedicareRx Programs
To appropriately manage the formulary and patient care, a utilization management tool (for example, prior authorization, quantity limits, and step therapy) applies to select drugs.
Prior Authorization
Prior authorization is required on some medications. This means that specific criteria must be met before a drug is covered.
View criteria en Español
Quantity Limits
Quantity limits are applied to certain drugs based on the approved dosing limits established during the Food and Drug Administration (FDA) approval process. Quantity limits are applied to the number of units dispensed for each prescription.
View criteria en Español
Step Therapy
Step therapy requires the use of one or more specific drugs prior to the use of a more potent dosage or higher quantities of a drug are provided.
View criteria en Español
Medication Therapy Management Programs
Blue MedicareRx offers medication management programs for members who have multiple chronic conditions, who are taking many prescription drugs, or who have high drug costs. These programs were developed for Blue MedicareRx by a team of pharmacists and doctors.
We use these medication management programs to help us provide better care for our members. For example, these programs help us make sure that our members are using appropriate drugs to treat their medical conditions and help us identify possible medication errors. Please note that these programs may have limited eligibility criteria and are not considered a benefit under Blue MedicareRx.
To learn more about our medication management programs, or to join a program, contact a Product Specialist.
Drug Utilization Review
Blue MedicareRx conducts drug utilization reviews for all of our members to ensure they are receiving safe and appropriate care. These reviews are especially important for members who have more than one doctor prescribing their medications.
We conduct drug utilization reviews each time you fill a prescription and on a regular basis by reviewing our records. During these reviews, Blue MedicareRx looks for medication problems such as:
- Possible medication errors
- Duplicate drugs that are unnecessary because you are taking another drug to treat the same medical condition
- Drugs that are inappropriate because of your age or gender
- Possible harmful interactions between drugs you are taking
- Drug allergies
- Drug dosage errors
If Blue MedicareRx identifies a medication problem during our drug utilization review, we will work with your doctor to correct the problem.
* Some network pharmacies are not preferred, and therefore do not offer lower copays for a 90-day supply.
PrimeMail is offered by Prime Therapeutics. Prime Therapeutics is a separate company from Blue Cross and Blue Shield of Oklahoma and provides pharmacy benefit management services for BlueMedicareRx.
Need Assistance?
Blue MedicareRx
Call 1-877-282-3785
This information is available for free in other languages. Please contact our Customer Service number at 1-877-282-3785 for additional information. (TTY/TDD users should call 711). Hours are 8 a.m. - 8 p.m., local time, 7 days a week. From February 15th through October 14th alternate technologies (for example, voicemail) will be used on the weekends and holidays. Customer Service also has free language interpreter services available for non-English speakers. en Español
Contact us:
Blue MedicareRx
P.O. Box 3897
Scranton, PA 18505-9947
A Division of Health Care Service Corporation, a Mutual Legal Reserve Company,
an Independent Licensee of the Blue Cross and Blue Shield Association.
© Copyright 2012. Health Care Service Corporation. All Rights Reserved.
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Important Information about Blue MedicareRx
SM Service Mark of the Blue Cross and Blue Shield Association, an Association of Independent Blue Cross and Blue Shield Plans.
® Registered Service Marks of the Blue Cross and Blue Shield Association, an Association of Independent Blue Cross and Blue Shield Plans.
Blue Cross and Blue Shield of Oklahoma refers to HCSC Insurance Services Company, which is a wholly owned subsidiary of Health Care Service Corporation, a Mutual Legal Reserve Company. These companies are independent licensees of the Blue Cross and Blue Shield Association and offer or provide services for stand-alone prescription drug plans with a Medicare contract under contract number S5715 with the Centers for Medicare and Medicaid Services.
A stand-alone prescription drug plan with a Medicare contract.
Last Updated 01202012S5715_WEB_OK_PDP12d
CMS Approved 02022012
