Drug Formulary (Preferred Drug List)
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Home Delivery Form (Group)
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Prior Authorization Form
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Utilization Management Criteria
Rx Drug Benefit Programs

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• Coinsurance/Deductible Programs
• BlueCare Non-Group

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Rx Drug Benefit Portal

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Medicare Part D Information
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Blue Cross of Northeastern Pennsylvania offers coverage for prescription drugs when medically necessary and dispensed by participating pharmacies. We use the Express Scripts Inc., national pharmacy network.

Blue Cross of Northeastern Pennsylvania uses a prescription drug formulary, also known as a Preferred Drug List. The formulary is a list of the most effective drugs at the most cost-effective prices, which have been approved by participating doctors and pharmacists for your use.

If you have questions on your prescription drug coverage, call Express Scripts* anytime at 1-877-603-8399 or log on to your personal information at the Express-Scripts member portal.

*Blue Cross of Northeastern Pennsylvania provides prescription drug coverage with administrative assistance from Express Scripts, Inc., an independent pharmacy management company not affiliated with the Blue Cross and Blue Shield Association.

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