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Blue Access for Members and quoting tools will be unavailable from 2am - 5am on Saturday, October 20.
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Due to system maintenance, BAM may experience a brief outage between 6am and 10am CST on March 9, 2014.
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This information can help you and your doctor get the most from your prescription drug coverage.
This is only a brief description of some of the prescription drug benefits. Not all benefits are offered by all health plans. For more complete details, including benefits, limitations and exclusions, please refer to your benefit materials.
Use the downloadable forms below to file claims and request changes. Note: If the PDF forms are altered in any way, they will not be processed by Blue Cross and Blue Shield of New Mexico (BCBSNM).
All the files below are available as PDFs. You will need the Adobe® Reader® to access these files, which you can download for free at Adobe's site .
A Drug List is a list of preferred drugs that are available to BCBSNM members. These drugs are considered to be safe and cost-effective. A prescription drug list is sometimes called a formulary. How much you pay out-of-pocket for prescription drugs is determined by whether your medication is on the Drug List. Your doctor should consult the Drug List when prescribing drugs for you.
In 2014, your prescription drug benefits through BCBSNM may be based on either a Standard Drug List or a Generics Plus Drug List. The Generics Plus Drug List is a smaller version of the Standard Drug List. It includes mostly generic drugs and also includes brand-name drugs. The Generics Plus Drug List covers all the major classes of drugs. Generic drugs usually cost less than brand-name drugs, and this saves money.
Starting January 1, 2014, here are Preferred Drug Lists for BCBSNM health plans (off the Exchange).
2014 Individual Plans and Small Group (SHOP) Plans (group size 2–50 members) — Coverage begins January 1, 2014
The Drug Lists below are used with BCBSNM health plans available through the Exchange. In 2014, your prescription drug benefits through BCBSNM may be based on either a Standard Drug List or a Generics Plus Drug List. The Generics Plus Drug List is a smaller version of the Standard Drug List. It includes mostly generic drugs and also includes brand-name drugs. The Generics Plus Drug List covers all the major classes of drugs. Generic drugs usually cost less than brand-name drugs, and this saves money.
Want to know which Drug List your Exchange plan uses? Check the charts below.
If your health plan includes BCBSNM prescription drug benefits, these are administered by Prime Therapeutics, our pharmacy benefits manager (PBM).
Visit Prime Therapeutics to:
The Specialty Pharmacy Program is designed to assist members who require self-administered specialty medications.
Specialty medications are:
Learn about program advantages, review drug list information and view more information on the Specialty Pharmacy Program.
If you have coverage through Blue Cross and Blue Shield of New Mexico, vaccinations may be covered under the medical benefit or prescription drug benefit, based on your plan. Select vaccines can be conveniently administered at a pharmacy near you. These vaccines can help protect you and covered family members from illnesses such as the flu, pneumonia, shingles, rabies, hepatitis B, tetanus, diphtheria and pertussis.
To see which vaccines are covered under your plan, check your benefit materials for details and any necessary copays. Or, you can call the Pharmacy Program number on the back of your ID card.
More information is available in the pharmacy vaccine program member flier .
For more information about BCBSNM prescription drug benefits:
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