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Quarterly Pharmacy Formulary Change Notice Effective August 1, 2019

The formulary changes listed in the table below were reviewed and approved at the first quarter Pharmacy and Therapeutics Committee meeting.

What this means to me:

  • Effective August 1, 2019, nonpreferred and prior authorization requirements will apply.
  • This notice applies to Healthy Blue.

View the full bulletin to see the Quarterly Pharmacy Formulary Change Notice table.

What action do I need to take?

Please review these changes and work with your Healthy Blue patients to transition them to formulary alternatives. If you determine preferred formulary alternatives are not clinically appropriate for specific patients, you will need to obtain prior authorization to continue coverage beyond the applicable effective date.

What if I need assistance?

We recognize the unique aspects of patients’ cases. If for medical reasons your Healthy Blue patient cannot be converted to a formulary alternative, call our Pharmacy department at 866-902-1689 and follow the voice prompts for pharmacy prior authorization.

You can find the Preferred Drug List on our website by visiting and selecting Providers. If you need assistance with any other item, contact Provider Services at 866-757-8286.