Jump to Content
Drugs, drug plans and vaccines
Medicare Advantage-prescription drug program and Prescription BlueSM
Medicare Part D prescription coverage may be included with a member's Medicare Plus Blue coverage (known as a Medicare Advantage prescription drug plan), or the member may have purchased Prescription Blue separately.
Prescription Blue, is a freestanding Medicare Part D prescription drug program offered by BCBSM.
Check the member ID card and summary of benefits for more member information:
- Medicare Plus Blue PFFSSM benefit summaries
- Medicare Plus Blue PPOSM benefit summaries
- Prescription BlueSM benefit summaries (PDF)
Prescription drug formularies and more information
BCBSM's Web site provides a wealth of information about our Medicare Plus Blue PFFS and Medicare Plus Blue PPO drug formularies, as well as details about prior authorization/step therapy criteria and quantity limits.
Additional resources
- Determination Request Form (PDF)
- 2010 Medicare Part D Payer Sheet (PDF)
- 2009 Medicare Part D Payer Sheet (PDF)
- E-prescribing bonus payments
Vaccine roster billing information and forms
Flu and pneumonia vaccines are covered under Medicare Part B benefits and shouldn't be billed to the member's Medicare Part D plan.
- Roster Billing for Influenza and Pneumococcal Vaccines on the CMS-1450 (UB-04) (PDF)
- Roster Billing for Influenza and Pneumococcal Vaccines on the CMS-1500 Claim (PDF)
- BCBSM Medicare Advantage Plan Influenza A (H1N1) Immunization Roster (PDF)
- BCBSM Medicare Advantage Plan Influenza Immunization Roster (PDF)
- BCBSM Medicare Advantage Plan Pneumococcal Polysaccharide Virus (PPV) Immunization Roster (PDF)
Other vaccine coverage
Coverage for other vaccines may fall under Part A, Part B or Part D (PDF).
Polypharmacy Part D program
In the Polypharmacy Part D program, our team of clinical pharmacists reviews medication profiles for members who suffer from multiple chronic diseases and receive multiple drug treatments. We work with prescribing physicians to identify opportunities to improve safety, decrease drug costs, and maximize patient quality of life. Our team coordinates appropriate substitutions or dosage adjustments with the prescribing physician when drug combinations, efficacy, or dosage issues are identified.
