Members
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
- Prescription Mail Service Order Form If your policy has a mail-order medications benefit, use this form to order new and/or refill mail service prescriptions.
- Prior Authorization Form for Prescription Drugs (to be filled out by prescriber)
Employer coverage drug lists
- 2023 Standard with Step Formulary 4 Tier
- 2023 Standard with Step Therapy Drug List
- 2023 Metallic 5 Tier Formulary (for Standardized plans only)
- 2023 Metallic 6 Tier Formulary
- 2024 Standard with Step Formulary 4 Tier
- 2024 Standard with Step Therapy Drug List
- 2024 Metallic 5 Tier Formulary (for Standardized plans only)
- 2024 Metallic 6 Tier Formulary
If you need more information about your prescription drug coverage, call the number on the back of your ID card.