The basics of Wellmark drug formularies and what employees need to know
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Understanding Wellmark drug formularies
Wellmark's drug lists, or drug formularies, help your employees save money and avoid surprises at the pharmacy. It guides them through what prescription drugs are covered — and how they’re covered — by your company’s pharmacy benefit plan from Wellmark Blue Cross and Blue Shield. These lists are also developed to guide physicians, pharmacists and other health care professionals to cost-effective, safe medications.
Wellmark's formulary drug lists include:
- Blue Rx CompleteSM
- Blue Rx EssentialsSM
- Blue Rx PreferredSM
- Blue Rx ValueSM
- Blue Rx Value PlusSM
The prescription drugs and devices on each drug list have been approved by the Wellmark Pharmacy & Therapeutics (P&T) Committee. Depending on your pharmacy benefit design, each tier or level likely has a different cost share that your employee will pay at the pharmacy.
Help employees better understand their prescription drug coverage
Our easy‑to‑use flyer shows employees how to check which prescriptions are covered, understand drug tiers and find lower‑cost options so they can make more confident pharmacy decisions. Download the free Wellmark drug search tool flyer.
What's a drug tier or level?
Covered medications are grouped into tiers or levels, which determine how much your employee will pay at the pharmacy. The higher the tier or level, the more the medication will cost.
Generics and brand-name drugs are both covered. However, if a generic option is available, the employee may be required to pay more if the brand-name drug is dispensed instead.
Get the details on a specific prescription drug
Your employees can search their drug lists to see if any restrictions apply to their prescriptions, such as quantity limits or prior authorization, or if a drug is classified as preventive. They can also educate themselves on how to take it, possible side effects, drug interactions and even what it looks like.
Use myWellmark® for personalized information
By registering for myWellmark, your employees and their families have their benefits information — including pharmacy coverage — at their fingertips. myWellmark makes it easy to see which services and medications are covered by their specific plan and even keep tabs on their claims and spending.
Encourage your employees to review their drug formulary whenever they get a new prescription or change benefits.
Questions? Please reach out to your authorized Wellmark representative, or send us an email at blueatwork@wellmark.com.