Prescription drug benefits
Review your prescription drug benefits based on your medical plan option.
Prospective and existing members can compare prescription plan options by using the interactive Drug Calculator Tool to find estimated drug costs by plan. The tool provides estimated costs through retail or mail, shows lower cost alternative drugs and any specific requirements, such as whether the drug requires a prior authorization before it can be filled. You can access the tool by selecting your plan below:
- BlueChoice Advantage—HDHP Option
- Blue Value Plus Option Tool
- Standard Blue Choice
Services |
BlueChoice Advantage-HDHP Option |
Blue Value Plus Option |
Standard Blue Choice |
---|---|---|---|
Formulary |
2025 CareFirst Prescription Formulary 2 (PDF) 2025 CareFirst Preferred Drug List Formulary 2 (PDF) 2024 CareFirst Prescription Formulary 2 (PDF) |
2025 CareFirst Prescription Formulary 2 (PDF) 2025 CareFirst Preferred Drug List Formulary 2 (PDF) |
|
Rx Deductible | Combined Medical and Drug deductible ($1,600 Self-Only, $3,200 Self + One/Self and Family) | $100 Self Only $200 Self + One/Self and Family |
$0 |
Pharmacy (Retail up to a 34-day supply) | |||
Preventive Drugs Examples: folic acid, fluoride and FDA approved contraceptives for women |
$0, no deductible |
$0, no deductible | $0 |
Generic | $0, after deductible1 |
N/A | $0 |
Preferred Generic | N/A |
$10, no deductible | N/A |
Preferred Brand | $50, after deductible, $30 Insulin (no deductible) |
$50, after deductible, $30 Insulin (no deductible) | $50, $30 Insulin |
Non-preferred Brand | $75, after deductible, $30 Insulin (no deductible) |
N/A | $75, $30 Insulin |
Preferred Generic Specialty | N/A |
$100, after deductible2 | N/A |
Preferred Brand Specialty | $100, after deductible2 |
$150, after deductible2 | $1002 |
Non-preferred Specialty | $150, after deductible2 |
N/A | $1502 |
This summary is for comparison purposes only and does not create rights not given through the benefit plan.
1Select generics not subject to deductible.
2Specialty drugs limited to 34-day supply for first fill and change in fills. Specialty drugs must be filled through CVS Specialty Pharmacy.
* Preferred Brand Insulin not subject to deductible