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

Cost effective medical care
Services	BlueChoice Advantage-HDHP Option	Blue Value Plus Option
Formulary	2025 CareFirst Prescription Formulary 2 (PDF) 2025 CareFirst Preferred Drug List Formulary 2 (PDF)	2025 CareFirst Prescription Formulary 4 (PDF)
Rx Deductible	Combined Medical and Drug deductible ($1,650 Self-Only, $3,300 Self + One/Self and Family)	$100 Self Only $200 Self + One/Self and Family
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
Generic	$0, after deductible¹	N/A
Preferred Generic	N/A	$10, no deductible
Preferred Brand	$50, after deductible, $30 Insulin (no deductible)	$50, after deductible, $30 Insulin (no deductible)
Non-preferred Brand	$75, after deductible, $30 Insulin (no deductible)	N/A
Preferred Generic Specialty	N/A	$100, after deductible²
Preferred Brand Specialty	$100, after deductible²	$150, after deductible²
Non-preferred Specialty	$150, after deductible²	N/A

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