Provider Pharmacy Information

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.

Pharmacy Network

Drug Formulary

Brand name and generic prescription medications or drugs reimbursed at maximum payment levels.

Forms and Links:

Drug Formulary List - updated April 2020
Latest Additions and Deletions - updated April 2020
2019 BlueCare, BlueDirect, BlueEssential, BluePartnerand SimplyBlue Formulary - updated April 2020
2020 BlueCare, BlueDirect, BlueEssential, BluePartner and SimplyBlue Formulary - updated April 2020

Nonpayable Drugs

Prescription drugs not covered by BCBSND.

Nonpayable Drug List - updated December 2019

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:

Submit request electronically through CoverMyMeds
If you have not registered on this site, please do so.
OR
If you're unable to submit an electronic request, download a form from the Prime Therapeutics website using one of the links below, complete it and fax it to Prime Therapeutics at 877-480-8130.

See the guidelines for prior approval or have restricted-use drugs:

Forms and Links:

Restricted-Use Prior Approval Drugs - updated April 2020
Restricted-Use Opioids - updated April 2020
Restricted-Use Step Therapy Drugs - updated March 2020
Restricted-Use Insulin - updated April 2010
Restricted-Use Drug Dispensing Limits - updated January 2020

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 April 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