Pharmacy Benefits

Use these drug lists to see if your Blue Cross Complete plan covers your medicine.

The Blue Cross Complete Preferred Drug List and Specialty Drug Guide list the medicines we cover. They also tell you which medicines require prior authorization or may have other criteria.

You can also search online to see if your medicine is on the list of covered medicines.

*The Blue Cross Complete drug formulary has been updated as of June 1, 2016. You can also find information on the State of Michigan website

Preferred Drug List

Your prescription benefit covers most generic medicines. These are covered when prescribed by a Blue Cross Complete doctor and filled at a Blue Cross Complete pharmacy.

Specialty drugs

Specialty drugs are used to treat complex or rare conditions, such as arthritis, multiple sclerosis, hepatitis C and others. These drugs are listed on our Specialty Drug Guide.

Medicines covered by the state of Michigan

Some medicines are covered by the state of Michigan. This includes drugs used for HIV or AIDS, seizure disorders, sleep disturbances and certain types of mental illness. Some of the medicines covered by the state are shown on this list.

There may be a small copay for these medicines and you will need to show your mihealth card at the pharmacy. The mihealth card is your Michigan Medicaid card.

Members age 21 and older will have a copay. This means you pay a small charge for these medicines when you fill your prescription. The state's copay for these medicines is $1 for generic medicine and $3 for brand name medicine.

NOTE: The medicines on the Blue Cross Complete Preferred Drug List remain covered by Blue Cross Complete. You won't have a copay for medicines on this list. At the pharmacy, you'll show your Blue Cross Complete ID card.

Pharmacy Maximum Allowable Cost Pricing Review

The PerformRx Pricing Administration Department calculates generic Maximum Allowable Cost (MAC) and reimbursement to participating pharmacies. MAC prices are updated weekly. To request a MAC pricing review, email the PerformRx Pricing Administration Department or call the Customer Care Center at 1-888-989-0057.

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