Formulary for Healthy Blue
The medications included in the formulary for Healthy Blue are reviewed and approved by the Pharmacy and Therapeutics Committee, which includes Practitioners
and Pharmacists from the Provider community.
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.
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 the preferred agent for Healthy Blue, unless otherwise noted. If you have any questions about coverage of a
certain product, please contact us at 1-833-388-1406 from 8 a.m. to 9 p.m. CT Monday to Friday.
Healthy Blue is the trade name of Community Care Health Plan of Nebraska, Inc., and independent licensee of the Blue Cross and Blue Shield Association.
Healthy Blue State PDL click here.
To view the Over-the-Counter (OTC) drug list, click here. If the OTC products you are looking for are not found on the drug list or within the searchable formulary, the product is not covered.
Machine Readable Data for Prescription Drug
Formulary: Healthy Blue Machine Readable File