If your prescription drug is not listed in the formulary, first call Customer Service to verify it is truly not covered. You can reach us at 1-888-494-2583, we are available from 8 a.m. to 8 p.m. seven days a week. TTY users can call 1-800-377-1363.
Within the first 90 days of joining our plan you may request a one-time fill of a non-formulary drug. After your one-time fill we will send you a list of covered formulary drugs commonly used to treat your medical condition. You can ask your provider if any of the drugs on this list are an option for your treatment. You can also request a formulary exception (which is a type of coverage determination).
If Customer Service confirms that we do not cover your drug, you have three options:
Return this form using one of the following:
Mail: Blue Cross of Idaho, PO Box 8406, Boise ID 83707
Y0010_MK 13121 Approved 12-31-2012
Last updated 11-14-2012