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partner | anthem blue cross

PHARMACY (Rx)

You will automatically be enrolled in the prescription drug plan that is coupled with the medical plan you elected. To keep your costs low, make sure to explore all options with your doctor when being prescribed a medication. Most brand-name drugs have a generic equivalent that is equal in strength, purity and quality. Preventive medications are covered at 100% and are not subject to your deductible or coinsurance.

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(833) 261-2460

anthem.com/ca

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HMO | Retail Copay (30 Day Supply)

  • Tier 1 - Typically Generic | $10 Copay
  • Tier 2 - Typically Preferred Brand | $30 Copay
  • Tier 3 - Typically Non-Preferred Brand | $50 Copay
  • Tier 4 – Typically Specialty (brand and generic) Specialty | 30% coinsurance up to $250 copay

Mail Order Copay (90 Day Supply)

  • Tier 1 - Typically Generic | $20 Copay
  • Tier 2 - Typically Preferred Brand | $60 Copay
  • Tier 3 - Typically Non-Preferred Brand | $100 Copay
  • Tier 4 – Typically Specialty (brand and generic) Specialty | 30% Coinsurance up to $250 copay

PPO | RETAIL COPAY (30 DAY SUPPLY)

  • Tier 1 - Typically Generic | $10 Copay
  • Tier 2 - Typically Preferred Brand | 10% coinsurance up to $50 copay
  • Tier 3 - Typically Non-Preferred Brand | 10% coinsurance up to $70 copay
  • Tier 4 – Typically Specialty (brand and generic) Specialty | 30% coinsurance up to $250 copay

MAIL ORDER COPAY (90 DAY SUPPLY)

  • Tier 1 - Typically Generic | $20 Copay
  • Tier 2 - Typically Preferred Brand | 10% coinsurance up to $100 Copay
  • Tier 3 - Typically Non-Preferred Brand | 10% Coinsurance up to $140 copay
  • Tier 4 – Typically Specialty (brand and generic) Specialty | 30% Coinsurance up to $250 copay

RESOURCE LIBRARY

MANAGE YOUR PHARMACY ONLINE

Go to anthem.com/ca , log in and choose Pharmacy.  On your personal pharmacy page, select View Your Prescriptions.  

You can also search or print your drug list options at:  https://www.anthem.com/ca/pharmacyinformation/

Select: National 4-Tier Drug List.

The search results will include information on the pharmacy programs that may apply to their prescriptions i.e. prior authorization, step therapy, quantity limits, etc.

GET A MAIL ORDER PRESCRIPTION

Go to anthem.com/ca, log in and choose Pharmacy.  On your personal pharmacy page, select View Your Prescriptions under Switch to a 90-day Supply.

For the drugs you want to switch to home delivery, choose Switch to a 90-day Supply and then Select Prescriber.  You can also add or update your shipping address, shipping options and payment method on this page.

LEARN ABOUT PRIOR AUTHORIZATION
Most prescriptions are filled right away when you take them to the pharmacy.  But some drugs need to be reviewed by your health plan before they’re covered.  This process is called prior authorization.  Prior authorization focuses on drugs that may have a risk of side effects, a risk of harmful effects when taken with other drugs, potential for incorrect use or abuse, better options that may cost you less and work better, and rules for use with certain health conditions.  
 
You can view the list of drugs, details and updates when you log in at anthem.com/ca.
NATIONAL DRUG FORMULARY LIST

National Formulary List

To keep your costs low, make sure to explore all options with your doctor when being prescribed a medication. Most brand-name drugs have a generic equivalent that is equal in strength, purity and quality. Preventive medications are covered at 100% and are not subject to your deductible or coinsurance.