Your Drug Coverage
View drugs covered under your plan by selecting one of the documents below.

Refer to your printed benefit materials to find out the type of prescription plan your coverage offers and if other limitations apply. Search tip: After opening a formulary, hold the Ctrl key while pressing F on your keyboard 

2009 Drug Formularies:
2010 Drug Formularies:

Drug Coverage and Cost Details
To search all available covered drugs and to find out your price for each, visit the Express Scripts, Inc.* website. Login and choose "My Prescription Plan" then "Price a Drug." 

Specific Drug Coverage Requirements
Some drugs have special restrictions for coverage. This can include limits on each fill, pharmacy restrictions or physician authorizations. Lists of these restrictions are below.

• Quantity Per Dispensing (QPD) Level Limits/Allowances [PDF] Updated 06/12/2009
  

• Specialty Pharmacy Program Drug List [PDF] Updated 06/12/2009

• Drugs Requiring Prior Authorization [PDF] Updated 06/12/2009
  Physicians must call 1.800.842.2015 for authorization

Need to file a prescription claim?

Questions about your drug coverage?

• Visit the Express Scripts, Inc.* website
• Call Express Scripts Customer Service at 1.866.781.7533

*Express Scripts, Inc. (ESI) is an independent company that serves as the pharmacy benefit manager for Blue Cross and Blue Shield of Louisiana and HMO Louisiana, Inc.

Not all options apply to all benefit plans. Benefits and/or drug lists may have changed since this information was posted. Please call the customer service number on the back of your ID card for more information.

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