Healthy Indiana Plan Formulary (Basic Plan)
The medications included in the Anthem Blue Cross and Blue Shield (Anthem) formulary
are reviewed and approved by the Pharmacy and Therapeutics Committee,
which includes Practitioners and Pharmacists from the Provider community.
Please
select a drug from the list below to see all coverage details regarding the
medication. Some medications listed may have additional
requirements or limitations of coverage. These requirements and limits may
include prior authorization, quantity limits, age limits, step therapy or Center for Medicare and Medicaid Services (CMS) coverage requirements.
Medications not listed on the formulary are considered
to be non-formulary and are subject to prior authorization.
Additionally, if a medication is available as a
generic formulation, this will be Anthem's preferred agent, unless otherwise
noted. If you have any questions about coverage of a certain
product, please contact us at 1-800-533-1995.
Machine Readable Data for Prescription Drug
Formulary: Healthy Indiana Plan Basic Medicaid Machine Readable File