The drug lists below are used for BCBSMT "metallic" health plans that are offered through your employer. These can include Platinum, Gold, Silver, or Bronze plans.
If your company has 1–50 employees, your BCBSMT prescription drug benefits are based on a Drug List, which is a list of drugs considered to be safe and cost effective.
If you are a BCBSMT member, log in to your Blue Access for MembersSM account to check your drug list and learn more about your prescription drug benefits.
View your current drug list effective January 1, 2024:
- 2024 Drug List
- Women's Contraceptive Coverage List
- ACA $0 Preventive Drug List
- $0 HDHP-HSA Preventive Drug List (This applies only for Blue Preferred Gold PPOSM 135, Blue Preferred Gold PPOSM 123, Blue Preferred Gold PPOSM 101, Blue Preferred Silver PPOSM 136, Blue Preferred Silver PPOSM 127, Blue Preferred Silver PPOSM 122, Blue Preferred Silver PPOSM 101, Blue Preferred Bronze PPOSM 134, Blue Focus Gold POSSM 101, Blue Focus Silver POSSM 101, Blue Focus Silver POSSM 003 and Blue Focus Bronze POSSM 002 plans)
Starting January 1, 2024, some changes will be made to the prescription drug benefit. Review the 2024 changes.
This drug list coverage ended December 31, 2023, with the exception of a plan with an off-cycle 2024 renewal date. Check your benefit materials for details.
- 2023 Drug List
- $0 HDHP-HSA Preventive Drug List (This applies only for Blue Preferred Gold PPOSM 135, Blue Preferred Gold PPOSM 123, Blue Preferred Gold PPOSM 101, Blue Preferred Silver PPOSM 136, Blue Preferred Silver PPOSM 127, Blue Preferred Silver PPOSM 122, Blue Preferred Silver PPOSM 101, Blue Preferred Bronze PPOSM 134, Blue Focus Gold POSSM 101, Blue Focus Silver POSSM 101, Blue Focus Silver POSSM 003 and Blue Focus Bronze POSSM 002 plans)
Starting January 1, 2023, some changes were made to the prescription drug benefit. Review the 2023 changes.
You, your prescribing health care provider, or your authorized representative, can ask for a Drug List exception if your drug is not on (or is being removed from) the Drug List. To request this exception, you, your prescriber, or your authorized representative, will need to send BCBSMT documentation. To begin this process, you or your prescribing health care provider can call the number on your ID card for more information or fill out and submit the Prescription Drug Coverage Exception form. BCBSMT will let you, your prescriber (or authorized representative) know the benefit coverage decision within 72 hours of receiving your request. If the coverage request is denied, BCBSMT will let you and your prescriber (or authorized representative) know why it was denied and may advise you of a covered alternative drug (if applicable). You can also appeal the benefit determination.
If you have a health condition and failure to take the medication may pose a risk to your life, health or keep you from regaining maximum function, or your current drug therapy uses a non-covered drug, you, your prescriber, or your authorized representative, may be able to ask for an expedited review process. BCBSMT will let you, your prescriber (or authorized representative) know the coverage decision within 24 hours of receiving your request for an expedited review. If the coverage request is denied, BCBSMT will let you and your prescriber (or authorized representative) know why it was denied and may advise you of a covered alternative drug (if applicable). Call the number on your ID card if you have any questions. You can also appeal the benefit determination.
