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Prior Authorization and Quantity Limits The Wellmark Drug List helps guide physicians and pharmacists in choosing medications for you that provide the right treatment for the best price. A diverse group of doctors meet several times a year to update the list by analyzing new drugs and re-evaluating existing ones based on safety, cost and effectiveness. 

Formulary Drug Lists

Some benefit plans have a tiered design. That means whenever you have a prescription filled, the amount you pay depends on what tier the drug is on. Twice a year we review the Wellmark Drug List of covered drugs with a committee of statewide pharmacists and physicians with the intent of reducing costs for members. Sometimes the cost share, such as copayments and deductibles, for certain drugs may change. On Jan. 1, 2017, some changes will be made to the Wellmark Drug List. Review your formulary drug list below, or log in to myWellmark to see what drugs are covered or not covered based on your plan benefits, as your health plan may not cover all medications.

Blue Rx Basic List PDF File
Blue Rx Complete List PDF File
Blue Rx Essentials List  PDF File
Blue Rx Preferred List PDF File
Blue Rx Value List PDF File
Blue Rx Value Plus List  PDF File
BlueSimplicitySM Rx List PDF File

Some drugs, and certain amounts of some drugs, require an approval before they can be covered by your benefits. This process is called prior authorization. Most drugs are also limited to a maximum quantity you may receive in a single prescription. Federal regulations limit the quantity that may be dispensed for certain medications. If your prescription is so regulated, it may not be available in the amount prescribed by your doctor. In addition, coverage for certain drugs is limited to specific quantities per month, benefit year, or lifetime. Amounts in excess of quantity limitations are not covered by your plan benefits.