Prescription Drug Benefit Resources

A drug formulary is a list of FDA-approved drugs, carefully chosen by our Pharmacy and Therapeutics Committee for their medical effectiveness and value.

Formulary
An easy-to-use drug formulary search tool that allows members to search by alphabetical drug name or drug class. You can also check here for drugs recently added to or removed from the formulary.
Formulary for: Keystone 65 Complete | All other plans

Generic and Brand-Name Drugs
Our plan covers both brand-name drugs and generic drugs. Generic drugs have the same active-ingredient formula as a brand-name drug. Generic drugs usually cost less than brand-name drugs and are rated by the Food and Drug Administration (FDA) to be as safe and effective as brand-name drugs.

Prior Authorization Submission
Some medications on our formulary will require prior authorization. This means that your doctor will have to get approval in advance from Independence Blue Cross.
Prior Authorization for: Keystone 65 Complete | All other plans

Exceptions and Appeals
If you and your doctor agree you need medication that we don’t cover and no alternative is available you may want to appeal our decision or ask for an exception.

Transition Process
How we ensure that your medication is not interrupted as you change over to our plan or if there are changes in your care.
Transition Process for: Keystone 65 Complete | All other plans

Pharmacy Network
Your prescriptions are covered at more than 65,000 national chain, independent, long-term care, and home-infusion pharmacies (more than 11,000 for Keystone 65 Complete).
Network for: Keystone 65 Complete | All other plans

Quality Assurance
Before you receive your prescription, these are the checks to make sure you’re getting the right medicine.

Explanation of Benefits Tutorial
This is an interactive tutorial to help you understand your Explanation of Benefits and answer common questions regarding your prescription benefits.
Explanation of Benefits for: Keystone 65 Complete | All other plans