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Rx Drug Benefits

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Rx Drug Benefits Designed
to Meet Your Everyday Needs

Your Blue Cross of Northeastern Pennsylvania health insurance plan offers coverage for prescription drugs and supplies that are listed on our formularies and when filled by in-network pharmacies.

  • You must use the Express Scripts pharmacies that participate with Blue Cross of Northeastern Pennsylvania.
  • You must use one of Blue Cross of Northeastern Pennsylvania’s prescription drug formularies, also known as preferred drug lists.

Your Prescription Drug Plan

Blue Cross of Northeastern Pennsylvania offers several prescription drug benefit programs to meet your needs. Blue Cross of Northeastern Pennsylvania’s individual myBlue® plans and CHIP have the multi-tiered program.

If your employer offers prescription drug coverage through Blue Cross of Northeastern Pennsylvania, your group plan may have either the multi-tiered or coinsurance program. Check with your employer, or if you are already a member, check the prescription drug booklet you received in your open enrollment kit or handbook kit.

Need More Info?

If you have questions on your Blue plan’s prescription drug coverage, call Express Scripts anytime at 1.877.603.8399 or logon to the Express-Scripts member self-service site to view your coverage information. You can also manage your pharmacy benefit anywhere with the Express Scripts mobile application. Visit Express-Scripts.com/mobile to download Express Rx for FREE today!

Prior Approval

You may need prior approval (authorization) for these drugs to be covered by your plan, as identified in our formularies. Your doctor needs to complete and submit a prior authorization form to Blue Cross of Northeastern Pennsylvania electronically or by fax before you get your prescription filled.

Specialty Drugs and Pharmacies

Check this list to see which specialty drugs are covered and available only at specialty pharmacies, as identified in our formularies. Learn more about specialty drugs and health care costs from our medical director.

Step Therapy

You may have to follow step therapy guidelines for certain drugs to be covered, as identified in our formularies. Read this flyer for a better understanding of step therapy.

Home Delivery

The home delivery program lets you save money on most maintenance medications taken long term and delivers them right to your home.

Drug Safety

Check out the U.S. Food and Drug Administration’s website to stay informed about drug recalls and safety alerts.


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