The BCBSND pharmacy program incorporates our philosophies around a holistic view of health. It also provides tools to help us collectively consider the value of drug benefits, monitor drug safety and improve health outcomes for North Dakotans.
Pharmacy search
Search for participating online and retail pharmacies.
Drug formulary
Brand name and generic prescription medications or drugs reimbursed at maximum payment levels.
Forms and links:
2022 Drug Formulary List - updated April 2022
Latest Additions and Deletions - updated April 2022
2022 BlueCare, BlueDirect, BlueEssential, BluePartner, BluePrime and SimplyBlue Formulary - updated May 2022
2021 BlueCare, BlueDirect, BlueEssential, BluePartner, BluePrime and SimplyBlue Formulary - updated May 2022
Nonpayable drugs
Prescription drugs not covered by BCBSND.
Nonpayable Drug List - updated April 2022
Restricted-use drugs
Drugs that have a dispensing limit, step therapy requirement and/or require prior approval from our pharmacy partner, Prime Therapeutics.
To submit a prior approval authorization request:
See the guidelines for prior approval or have restricted-use drugs:
Forms and Links:
Restricted-Use Prior Approval Drugs - updated May 2022
Restricted-Use Opioids - updated May 2022
Restricted-Use Step Therapy Drugs - updated January 2022
Restricted-Use Insulin - updated January 2022
Restricted-Use Drug Dispensing Limits (BCBSND Formulary) - updated April 2022
Restricted-Use Drug Dispensing Limits (BlueCare, BlueDirect, BlueEssential, BluePartner, BluePrime and SimplyBlue Formulary) - updated April 2022
Retail pharmacy medical policy
We partner with Prime Therapeutics to validate and approve retail pharmacy medical policies which are available on their website.
Speciality drugs
Medications or drugs that are generally high cost and may have other considerations such as special administration, limited availability, unique delivery and dispensing, or unique and/or required patient support or monitoring.
Specialty Drug List - updated May 2022
Value Based Design (VBD) drug list
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.
2022 HSA Preventive Drug - updated January 2022
2021 BlueDirect, BluePartner HDHP Preventive Drug
2022 BlueDirect, BluePartner HDHP Preventive Drug - updated January 2022
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 - updated January 2022
Routes of Administration Self-Administered Drug List - updated January 2022
NetResults
Information specific to NetResults
2022 NetResults Formulary - updated April 2022
2022 NetResults HSA Preventive Drug List - updated January 2022
2022 NetResults Value Based Design Drug List - updated January 2022
NetResults Restricted Use List - Opioids - updated May 2022
NetResults Quantity Limit Program Summary - updated April 2022
