Resources

Blueprint Portal is one of our members’ best resources for managing your pharmacy benefits and viewing claims. By registering today, you can access the Pharmacy Center that includes:

• Your detailed prescription claims history
• Plan-specific information around your pharmacy benefits
• Mail order information
• Drug coverage and cost tools
• Pharmacy Finder

Forms

• Prescription Claim Form [pdf]
• Prescription Mail Service Order Form [pdf]
  If your policy has a mail-order medications benefit, use this form to order new and/or refill mail service prescriptions.
• Prior Approval Form for Prescription Drugs [pdf] (to be filled out by prescriber)

Employer coverage drug lists

• 2023 Standard with Step Formulary 4 Tier [pdf]
• 2023 Standard with Step Therapy Drug List [pdf]
• 2023 Metallic 5 Tier Formulary (for Standardized plans only) [pdf]
• 2023 Metallic 6 Tier Formulary [pdf]

If you need more information about your prescription drug coverage, call the number on the back of your ID card.

Drug pricing

View Drug pricing

More information

• Step Therapy Clinical Documentation
• Disposing of Medications
• Pharmacy 90-day prescription supply [pdf]
• Pharmacy maintenance choice 90-day [pdf]
• Pharmacy maintenance choice 100-day [pdf]
• Using your Pharmacy benefits [pdf]
• Using your Pharmacy benefits - Spanish [pdf]