2025 Medication Lookup
If you are an individual plan member, use the Medication Lookup tools to learn whether our Medicare Advantage plans cover your Medicare Part D prescription medications.
In some cases, retail drugs and supplies are covered under your Part B of Original Medicare medical benefit (e.g. lancets, test strips). By law, certain types of drugs or categories of drugs are not covered under Medicare Part D.
The formulary was last updated on 06/01/2025 and may change during the year.
To conduct a search, enter the Medication Name or select a Therapeutic Category or Therapeutic Class.
Important Message About What You Pay for Vaccines - Our plan covers most Part D vaccines at no cost to you, even if you haven’t paid your deductible (if applicable.) Call Member Services at the number below for more information.
Important Message About What You Pay for Insulin - You won’t pay more than $35 for a one-month supply of each insulin product covered by our plan, no matter what cost-sharing tier it’s on even if you haven’t paid your deductible, if applicable.
2025 Medicare HMO Blue Formulary
(Updated 06/01/2025)
2025 Medicare PPO Blue Formulary
(Updated 06/01/2025)
For certain prescription drugs, we have additional requirements for coverage or limits on our coverage. This ensures that our members use these drugs in a safe way. Visit the Prior Authorization and Step Therapy section for more information.
Blue Cross Blue Shield of Massachusetts Medicare Advantage Plans cover 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.
Your Medicare Part D prescription benefit is a 5-tier structure. For more information about tiers, please see your summary of benefits. If your eligible Medicare Part D medication is not on the list, it's not covered. You may ask us to cover a Medicare Part D medication not listed on our formulary by requesting a formulary exception to waive coverage restrictions or limits on your medication. Visit the Appeals & Grievances section for more information.
Also, displayed are some medications and supplies covered under your Part B of Original Medicare medical benefit. These medications and supplies are available at network retail pharmacies. However, they do not qualify for exception requests, extra help on drug costs,transition fills, or accumulate toward your total out of pocket costs to bring you through the coverage gap faster like drugs covered under your Medicare prescription drug benefit. You pay nothing for these drugs and supplies covered under your Original Medicare medical benefit.
Contact us
- 1-800-200-4255 | TTY: 711
- April 1 through September 30, 8:00 a.m. to 8:00 p.m. ET, Monday through Friday.
- October 1 through March 31, 8:00 a.m. to 8:00 p.m. ET, seven days a week.
Blue Cross and Blue Shield of Massachusetts is an HMO and PPO Plan with a Medicare contract. Enrollment in Blue Cross Blue Shield of Massachusetts depends on contract renewal. Anthem Insurance Companies, Inc., Blue Cross and Blue Shield of Massachusetts, Inc., Blue Cross & Blue Shield of Rhode Island, and Blue Cross and Blue Shield of Vermont are the legal entities that have contracted as a joint enterprise with the Centers for Medicare & Medicaid Services (CMS) and are the risk-bearing entities for Blue MedicareRx (PDP) plans. The joint enterprise is a Medicare-approved Part D Sponsor. Enrollment in Blue MedicareRx (PDP) depends on contract renewal.
The benefit information provided is a brief summary, not a complete description of benefits. For more information, contact the plan. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, premium and/or copayments/co-insurance may change on January 1 of each year. You must continue to pay your Medicare Part B premium.
Y0014_24100_M
S2893_2432
Last Updated: 06/01/2025