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PHARMACY & PRESCRIPTIONS (BLUECARE PLUS TENNESSEE)

Prescription drug coverage plus extra support

We care about more than just covering your drugs. Your care team will answer your questions, help with refills and more.

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See if your medications are covered

Here’s your covered drug list.

2024 Medicare with Medicaid (BlueCare Plus) Medication List (Formulary)

(Updated: 10/1/2024)

2025 BlueCare Plus Tennessee Medication List (Formulary)

(Updated: 10/1/2024)

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See pharmacies in your area

We can help you find a pharmacy that's near you and in your network.

Pharmacy Directory
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Medicare Prescription Payment Plan

New for 2025, BlueCare Plus Choice (HMO D-SNP)℠ members who have prescription copays can pay for prescriptions over time with monthly payments. The payment is based on total prescription cost and the number of months left in the year. Click here to learn more. If you need help,  give us a call at 1-800-332-5762, TTY 711 seven days a week from 8 a.m. to 9 p.m. ET.

New for 2025, BlueCare Plus Choice (HMO D-SNP)℠ members who have prescription copays can pay for prescriptions over time with monthly payments. The payment is based on total prescription cost and the number of months left in the year. Click here to learn more. If you need help,  give us a call at 1-800-332-5762, TTY 711 seven days a week from 8 a.m. to 9 p.m. ET.

MORE ABOUT MEDICATION THERAPY MANAGEMENT
How do I opt-in or opt-out of the Medicare Prescription Payment Plan program?

You can sign up through your online account or by printing and filling out this PDF. Please see Terms and Conditions for additional information.

If you had an urgent prescription filled that you paid for before we received and processed your enrollment in the Medicare Prescription Payment Plan, you may be able to get a retroactive election into the program. You can get a retroactive election if:

  • You think any delay in getting your prescription would harm your life, health or ability to function.
  • You ask for the retroactive enrollment within 72 hours of filling your urgent prescription.

Once you’re enrolled in the plan, we’ll reimburse you for any cost-share you paid for your urgent prescription and any other covered Part D prescription filled between the urgent claim and the date your payment plan started. We’ll reimburse you within 45 days of your enrollment date.

If we determine you didn’t ask for retroactive election within the required timeframe, we’ll let you know and give you instructions on how to file a grievance.

How do I submit a complaint?

Learn more about making a complaint here.
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Medication Therapy Management (MTM)

Medication Therapy Management (MTM) is a program we offer eligible Medicare Advantage Prescription Drug plan members. It’s intended to help improve medication use, lower the risk of medication interactions and help members take medications as prescribed. The program includes a one-on-one consultation with a pharmacist or other qualified provider to review your prescription and over-the-counter medications. This is called a comprehensive medication review (CMR). It’s designed just for you and usually takes around 15-20 minutes. At the end of the review, you’ll get a copy of your list of medications and any topics you discussed.

During your personalized review, the pharmacist or other qualified provider will talk with you about:

  • Whether your medications are working like they should
  • Whether you’re having any side effects from your medications
  • Whether there are lower cost medications on your plan’s covered drug list that you could discuss with your prescriber to see if they might be right for you
  • Locations where you can safely throw away unused medications

MORE ABOUT MEDICATION THERAPY MANAGEMENT
Who’s eligible for this program?

To be eligible in 2024, you must:

  • Have three or more of these ongoing or chronic health issues:
    • Asthma
    • Chronic Heart Failure (CHF)
    • Chronic Obstructive Pulmonary Disease (COPD)
    • Depression
    • End-Stage Renal Disease (ESRD)
    • High cholesterol
  • Take eight or more prescriptions, and
  • Have spent $1,332.50 on medications in the past three months

In 2025, eligibility will change to:

  • Have three or more of these ongoing or chronic health issues:
    • Alzheimer’s Disease
    • Bone Disease - Arthritis (Osteoporosis, Osteoarthritis, and Rheumatoid Arthritis)
    • Chronic Heart Failure
    • Diabetes
    • Dyslipidemia
    • End-stage Renal Disease
    • HIV/AIDS
    • Hypertension
    • Mental Health - (Depression, Schizophrenia, Bipolar Disorder, and other Chronic and Disabling Mental Health Conditions)
    • Respiratory Disease (Asthma, Chronic Obstructive Pulmonary Disease (COPD), and other Chronic Lung Disorders)
  • Have spent $405.75 on medications in three months

Members in the Drug Management Program will be automatically enrolled.

What do I need to do to enroll?

You don’t have to do anything. You’ll be automatically enrolled if you’re eligible. We’ll send you a letter to notify you. Once you’re enrolled, you’ll get the yearly comprehensive medication review, which includes an updated medication list and safe drug disposal tips. You’ll also get quarterly targeted medication reviews (TMRs) that look for changes in the drugs you take that might need to be addressed with your prescriber. We’ll send your prescriber a fax with suggested changes if necessary. Your MTM pharmacist or other qualified provider will also follow up with you, if needed.

You don’t have to participate in the MTM program if you don’t want to, and the MTM program doesn’t impact your plan Part D benefits, copays, coverage, or providers and pharmacies that may be in your plan’s network. You can decline certain parts of the MTM program and still stay enrolled, too.

Here are some of the resources to help you prepare for your comprehensive medication review:

PDF Icon | BCBS of TennesseeBlank medication List

PDF Icon | BCBS of TennesseeDrug Disposal Information

Questions? Give us a call at the Member Service number on the back of your Member ID card.