Prescription Drugs
If you are enrolled in an Independence Blue Cross (IBC) plan with Medicare Part D coverage, your covered drugs are listed in the IBC Drug Formulary.
2012 Drug Formularies
Search 2012 IBC Drug Formulary (Keystone 65 Preferred and Personal Choice 65)
This easy-to-use formulary search tool allows you to search alphabetically by drug name or by drug class. You can also check here for drugs recently added to or removed from the formulary.
Search 2012 Keystone 65 Select HMO Formulary
2012 Keystone 65 HMO and Personal Choice 65 PPO Formulary Y0041_HM12_14 File & Use 09/03/2011
2012 Keystone 65 Select HMO Formulary Y0041_H3952_KS12_11 File & Use 08/31/2011
Understand the Basics of Your Prescription Drug Benefits
The IBC Drug Formulary
The IBC Drug Formulary is a list of drugs approved by the U.S. Food and Drug Administration (FDA), carefully chosen by our Pharmacy and Therapeutics Committee for their medical effectiveness and value.
Generic and Brand-Name Drugs
IBC covers both brand-name drugs and generic drugs. Generic drugs have the same active-ingredient formula as a brand-name drug, but generic drugs usually cost less and are rated by the FDA to be as safe and effective as brand-name drugs.
Prior Authorizations
Some medications on our formulary will require prior authorization. This means that your doctor will have to get approval in advance from Independence Blue Cross.
Exceptions and Appeals
If you and your doctor agree you need medication that we don’t cover and no alternative is available you may want to appeal our decision or ask for an exception.
Transition Supply Process
How we ensure that your medication is not interrupted as you change over to our plan or if there are changes in your care.
The IBC Pharmacy Network
Your prescriptions are covered at more than 65,000 national chain, independent, long-term care, and home-infusion pharmacies.
Quality Assurance
Before you receive your prescription, these are the precautions we take to make sure you’re getting the right medicine.
You must continue to pay your Medicare Part B premium.
The Medicare Contract is renewed annually, and the availability of coverage beyond the end of the current year is not guaranteed.
The benefit information provided herein is a brief summary, not a comprehensive description of benefits. For more information contact the plan. Benefits, formulary, pharmacy network, premium and/or copayments/coinsurance may change January 1, 2013. Members may enroll in the plan during specific times of the year. Contact the plan for more information. Please reference the Evidence of Coverage for information on premiums, cost-sharing, out-of-network coverage, rights and responsibilities upon disenrollment and any applicable conditions associated with using the plan benefits, as well as limitations, copayments, and restrictions. Members must use network pharmacies to access their prescription drug benefit, except under non-routine circumstances, and quantity limitations and restrictions may apply.
You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for extra help, call:
- 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/7 days a week;
- The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or
- Your State Medicaid Office.
People with limited incomes may qualify for Extra Help to pay for their prescription drug costs. If you qualify, Medicare could pay for up to seventy-five (75) percent or more of your drug costs including monthly prescription drug premiums, annual deductibles, and co-insurance. Additionally, those who qualify will not be subject to the coverage gap or a late enrollment penalty. Many people are eligible for these savings and don’t even know it. For more information about this Extra Help, contact your local Social Security office or call 1-800-MEDICARE (1-800-633-4227), 24 hours per day, 7 days per week. TTY users should call 1-877-486-2048.”
You must use plan providers except in emergency or urgent care situations or for out-of-are renal dialysis or other services. You must use plan providers except in emergency or urgent care situations or for out-of-are renal dialysis or other services. If you obtain routine care from out-of-network providers neither Medicare nor Keystone 65 HMO or Personal Choice 65 PPO will be responsible for the costs.
Please contact Keystone 65 HMO or Personal Choice 65 PPO Customer Service for more information.
Y0041_HM_12_300a Pending CMS Approval
- Generic and Brand Name
- Prior Authorization
- Exceptions and Appeals
- Transition Supply Process
- Pharmacy Network
- Quality Assurance
- Formulary
