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Your Pharmacy

Benefits

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You can view and download pharmacy information for your 2025 plan through December 31, 2025.

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Find a Doctor or Pharmacy

Search for a doctor or pharmacy in your health plan network.

You will need the name of your current health plan found on your ID card.(example: Capital Blue Cross Medicare PPO)

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Drug Formulary List/Compare Drug Prices

Compare the cost of your drugs at participating pharmacies.

To access pricing, login to your secure member account.

Search the Ideal Formulary for drugs included on the Capital Blue Cross Ideal formulary. This formulary applies to the following plans: Capital Blue Cross Complete, Enhanced, Select, and Value PPO, Capital Blue Cross Essential HMO and Capital Blue Cross | WellSpan PPO/HMO plans.

Download an Ideal Formulary listing. (updated 3/2025)
Ideal Formulary Prior Authorization Criteria
Ideal Formulary Step Therapy Criteria

Search the Classic Formulary for drugs included in the Capital Blue Cross Classic formulary. This formulary applies to the following plans: Capital Blue Cross Classic PPO, BlueJourney Prime PPO and BlueJourney Premier and Value HMO, as well as our Capital Blue Cross PPO and HMO Group benefit plans.

Download a Classic Formulary listing. (updated 3/2025)
Classic Formulary Prior Authorization Criteria
Classic Formulary Step Therapy Criteria

Drug Comparison Tool

Add your prescriptions to see how much you will pay each month and save by either switching to a pharmacy that has lower prescription cost or finding a lower cost alternative.

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Prescription Drug Management/Assistance

Help with Drug Costs - See if you qualify for help paying for your prescription drugs.

Out of Network Pharmacy Information - How to get reimbursed for prescriptions filled at an out-of-network pharmacy.

General Transition Notice - Explanation of the transition process of your current drugs when you switch to a different health plan.

Drug Utilization Management - If required, this process will ensure you are getting the proper drugs for your diagnosed condition.

Vaccine Finder - Are you having a difficult time finding where you can get a flu shot or the shingles vaccine? Use the Vaccine Finder to search your specific areas for what pharmacies have certain vaccines available now!

Part B Step Therapy - A process used to try a lesser expensive drug before going with the top brand drug.

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Medication Therapy Management (MTM)

Medication Therapy Management is a free educational program to help control long-term conditions for members who have multiple chronic diseases.

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Prescription Drug Request Forms

Medicare Coverage Determination Form - Use this form when your doctor or pharmacist tells you a prescribed drug will not be covered by your plan.

Pharmacy Reimbursement Form - To request reimbursement for a drug purchased at an out-of-network pharmacy.

Prescription Mail Order Information

Our plan’s mail order service allows you to order at least a 30-day supply of a drug and a 100-day supply.

Our primary mail order pharmacies options are listed below for your convenience.

To get information about filling your prescription by mail through Express Scripts Pharmacy, contact Express Scripts Pharmacy at 1.833.715.0946, (TYY users should call 711), 24 hours a day, 7 days a week. Or print and mail the Express Scripts mail order form.

To get information about filling your prescription by mail through Amazon Pharmacy, contact Amazon Pharmacy at 1.855-965-4956, (TYY users should call 711), 24 hours a day, 7 days a week.

Get started using this vanity URL in the click here. If you are already an Amazon customer, follow the simple sign-up process for Amazon Pharmacy. If you’re not yet an Amazon customer you’ll need to sign up, validate yourself and then follow the instructions.

For more information about our plan’s mail order service, please review Chapter 5 of your Evidence of Coverage booklet.

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¹Mark Cuban Cost Plus Drug Company, PBC is contracted through Prime Therapeutics LLC to provide mail pharmacy services to members of Capital Blue Cross. On behalf of Capital Blue Cross, Prime Therapeutics LLC assists in the administration of our prescription drug program. Prime Therapeutics LLC is an independent pharmacy benefit manager.