Prescription Drug Resources
Get the most from your prescription drug coverage with these helpful guides for both you and your doctor. Use the forms to file claims and request changes.
Note: Forms on this page are available as PDF files. Just click on the appropriate form to view, download and print. You will need the Adobe® Reader® to access these files, which you can download for free at Adobe's site 
. If these downloadable PDF forms are altered in any way they will not be processed by Blue Cross and Blue Shield of New Mexico.
If your health plan includes BCBSNM prescription drug benefits, these are administered by Prime Therapeutics, our pharmacy benefits manager (PBM).
Visit Prime Therapeutics to:
- Search for prescription drugs
- Find a pharmacy
- Mail order refills online
- View status of coverage for your drugs
- Download forms and brochures
- Get drug cost estimates
The Pharmacy Benefit Drug List includes all Tier 2 brand drugs and a partial listing of generic drugs. Physicians are encouraged to prescribe drugs listed in this Pharmacy Benefit Drug List. Members are encouraged to show this List to their physicians and pharmacists.
Drug List Updates
Blue Cross and Blue Shield of New Mexico (BCBSNM) and the Prime Therapeutics National Pharmacy and Therapeutics (P&T) Committee regularly meet to make formulary recommendations. Updates to the BCBSNM Drug List are listed by P&T Committee meeting date. To confirm the effective date of drug additions or deletions to the Drug List (including information on generic alternatives) please review the committee recommendations below.
The Specialty Pharmacy Program is designed to assist members who require self-administered specialty medications.
Specialty medications are:
- Generally prescribed to treat chronic, complex medical conditions, such as multiple sclerosis, hemophilia, hepatitis C and rheumatoid arthritis
- Typically given by injection or infusion, but may be taken by mouth
- Often require careful adherence to treatment plans and have special handling or storage requirements
- Not always stocked by retail pharmacies
Learn about program advantages, review drug list information and view more information on the Specialty Pharmacy Program.
- Prescription Drug Claim Form
- PrimeMail New Prescription Order Form
- PrimeMail Refill Prescription Order Form
- Patient Medication List Form — English Spanish — Keep a record of your medications on hand to share with your doctor
- Synagis Prior Authorization Form
- BlueSalud (Medicaid Plans) – View an overview of BlueSalud, including a Prescription Drug section containing the detail on coverage for this plan
- Blue MedicareRx (Medicare Part D Plans) — BCBSNM provides an easy choice for Medicare-approved Prescription Drug Coverage
- Express Scripts® – Pharmacy Benefits Manager for NMPSIA, NMRHCA, and State of New Mexico plan members
For more information about BCBSNM prescription drug benefits:
- Members — call the number printed on the back of your member ID card
- Employers and Producers — call your BCBSNM account representative
- Providers — call 1-800-325-8334, select option 5
