Lists of Covered Medications

View the formulary lists of prescription drugs covered under Vermont Blue Rx, as well as specialty medications and those requiring prior approval.

Formulary Drug Lists

To see the prescription drugs covered under your plan, you will need your ID card to help you determine which formulary will apply to you. Some plans exclude coverage for sexual dysfunction or fertility medications. To determine if a medication may be excluded, click on the formulary list below, enter the medication name, and review the corresponding member notes. Please reference your current plan documents through the Member Resource Center to confirm your coverage information. 

Blue Cross Formulary (BCBSVT on your ID card) National Performance Formulary (NPF on your ID card)
BCBSVT Formulary List NPF List

2022 BCBSVT Formulary Wellness List (eff. 07/01/22)

2022 NPF Wellness List (eff. 07/01/22)

 

NPF Exclusions (eff. 07/01/22)

 

Specialty Drug List

To verify that your specialty medicine is covered with Vermont Blue Rx, we encourage you to sign into the Member Resource Center and access our Specialty Pharmacy for the most up-to-date list of covered specialty medicines. You can also view the list below.

View the specialty drug list

You can purchase your specialty medicines through one of our preferred providers listed below and pay less. Be sure to verify that your specialty medication is covered with Vermont Blue Rx prior to having it filled. 

Pharmacy Name Phone Number
Optum Rx (844) 693-0163
Dartmouth-Hitchcock Medical Center (DHMC) Pharmacy (603) 653-3785
University of Vermont Medical Center (UVMMC) Pharmacy (802) 847-3784

Drugs requiring prior approval

Some drugs that are prescribed for medical use require separate Prior Approval. Please note under which benefit - Prescription Drug or Medical - your medication is prescribed by your provider. If you are covered under your employer's plan, please check with your benefits administrator as you may have a different coverage.

To request prior authorization or approval of an excluded medication, providers have the following options available:

  • Use CoverMyMeds (Member ID should include the last letter (usually V) followed by twelve numbers and the two-digit member number)
  • Call Vermont Blue Rx at (800) 313-7879

Unique packaging and therapeutic alternatives (UPTA) excluded drug list

View the list of drugs that are excluded from coverage due to unique packaging and/or where there is a therapeutic alternative.


Vermont Education Health Initiative — VEHI

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Lifestyle and Medication Guidance Program

We can help you learn more about the medications you take every day. Whether you’re curious about adverse side effects or if there is a lower-cost generic available to you — we can help. Take a moment to learn more about our Lifestyle and Medication Guidance program. As a Blue Cross member, it’s FREE and included in your plan!

Learn more