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.
Brand name and generic prescription medications or drugs reimbursed at maximum payment levels.
Forms and Links:
Drug Formulary List - updated July 2020
Latest Additions and Deletions - updated July 2020
2019 BlueCare, BlueDirect, BlueEssential, BluePartnerand SimplyBlue Formulary - updated September 2020
2020 BlueCare, BlueDirect, BlueEssential, BluePartner and SimplyBlue Formulary - updated September 2020
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 September 2020
Restricted-Use Opioids - updated August 2020
Restricted-Use Step Therapy Drugs - updated August 2020
Restricted-Use Insulin - updated August 2020
Restricted-Use Drug Dispensing Limits - updated July 2020
Retail Pharmacy Medical Policy
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 September 2020
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.
2020 HSA Preventive Drug - updated February 2020