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Pharmacy and drug tools

Get the most current information on drugs covered in your BCBSND health insurance plan.

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Call: 844-363-8457

Pharmacy tools

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Download and print the information that applies to you.

Drug Formularies

Brand name and generic prescription drugs reimbursed at maximum payment levels by BCBSND

BCBSND Formulary - updated October 2020
Latest Additions and Deletions - updated October 2020
2019 BlueCare, BlueDirect, BlueEssential, BluePartner and SimplyBlue Formulary - updated November 2020
2020 BlueCare, BlueDirect, BlueEssential, BluePartner and SimplyBlue Formulary - updated November 2020
2021 BlueCare, BlueDirect, BlueEssential, BluePartner, BluePrime and SimplyBlue Formulary

Nonpayable Drugs

Prescription drugs not covered by BCBSND

Nonpayable Drug List - updated October 2020

Restricted-Use Drugs

Drugs that have a dispensing limit and/or require prior approval

Restricted-Use Prior Approval Drugs - updated November 2020
Restricted-Use Opioids - updated November 2020
Restricted-Use Step Therapy Drugs - updated August 2020
Restricted-Use Insulin - updated August 2020
Restricted-Use Drug Dispensing Limits - updated July 2020

Specialty Drugs

Medications or drugs that are generally high in cost and/or require special administration, limited availability, unique delivery and dispensing, or patient support or monitoring

Specialty Drug List - updated November 2020

Value Based Design (VBD) Drug List

2021 BlueCare, BluePartner nonHDHP, BluePrime, SimplyBlue Value Based Design (VBD) Drug

HSA Preventive Drugs

Drugs covered under an HSA preventive drug benefit
The HSA Preventive Drug benefit is not included with all benefit plans. Please review your benefit plan materials to determine coverage. Contact customer service using the number on the back of your Insurance ID card with any questions.

2021 HSA Preventive Drug - updated November 2020
2020 HSA Preventive Drug - updated February 2020
2021 BlueDirect, BluePartner HDHP Preventive Drug

Over-the-Counter Medications

Non-prescription drugs covered by BCBSND when dispensed by a pharmacist upon receipt of a prescription order.

Over-the-Counter Medications List - updated November 2019

Excluded Route of Administration

A prescription medication or drug with an excluded pharmacy benefit route of administration will reject at pharmacy point of sale and may be covered under the medical benefit.

Routes of Administration Pharmacy Benefit Exclusion List

NetResults

Information specific to NetResults 

NetResults Formulary - updated October 2020
2021 NetResults HSA Preventive Drug List - updated November 2020
2020 NetResults HSA Preventive Drug List - updated January 2020
NetResults Value Based Design Drug List - updated November 2020
NetResults Restricted Use List - Opioids - updated November 2020
NetResults Quantity Limit Program Summary - updated April 2020

Where To Find Prescription Drug Information

Get information on your prescription drug coverage and usage:

Prime Therapeutics is an independent company that helps in the administer of BCBSND’s pharmacy benefits.