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Medication Lookup

The results below have been sorted using a 3-tier medication plan, which is our most common plan. For the most accurate search results, check your plan details and adjust the tier option above.
CADUET
THERAPEUTIC CLASS: Antihypertensive Combinations**
Select a strength to see details

5MG/20MG TABS

5MG/20MG TABS
Not Covered by a 3-Tier Plan
  • QCD

    Note Title
    Quality Care Dosing
    Definition
    To ensure safety and effectiveness, this medication, which is covered through the pharmacy benefit, has quantity and dosage limits that are recommended by the Food and Drug Administration (FDA). Review the Quality Care Dosing Guidelines in the Important Information section to learn more.
  • AAA NON COVERED

    Note Title
    Exceptions To Non Covered Medications
    Definition
    Your doctor may submit a request for an exception. If approved, the medication must still follow any applicable requirements before it can be covered by your plan. You’ll also pay the highest tier cost.

5MG/40MG TABS

5MG/40MG TABS
Not Covered by a 3-Tier Plan
  • QCD

    Note Title
    Quality Care Dosing
    Definition
    To ensure safety and effectiveness, this medication, which is covered through the pharmacy benefit, has quantity and dosage limits that are recommended by the Food and Drug Administration (FDA). Review the Quality Care Dosing Guidelines in the Important Information section to learn more.
  • AAA NON COVERED

    Note Title
    Exceptions To Non Covered Medications
    Definition
    Your doctor may submit a request for an exception. If approved, the medication must still follow any applicable requirements before it can be covered by your plan. You’ll also pay the highest tier cost.

5MG/80MG TABS

5MG/80MG TABS
Not Covered by a 3-Tier Plan
  • QCD

    Note Title
    Quality Care Dosing
    Definition
    To ensure safety and effectiveness, this medication, which is covered through the pharmacy benefit, has quantity and dosage limits that are recommended by the Food and Drug Administration (FDA). Review the Quality Care Dosing Guidelines in the Important Information section to learn more.
  • AAA NON COVERED

    Note Title
    Exceptions To Non Covered Medications
    Definition
    Your doctor may submit a request for an exception. If approved, the medication must still follow any applicable requirements before it can be covered by your plan. You’ll also pay the highest tier cost.

10MG/10MG TABS

10MG/10MG TABS
Not Covered by a 3-Tier Plan
  • QCD

    Note Title
    Quality Care Dosing
    Definition
    To ensure safety and effectiveness, this medication, which is covered through the pharmacy benefit, has quantity and dosage limits that are recommended by the Food and Drug Administration (FDA). Review the Quality Care Dosing Guidelines in the Important Information section to learn more.
  • AAA NON COVERED

    Note Title
    Exceptions To Non Covered Medications
    Definition
    Your doctor may submit a request for an exception. If approved, the medication must still follow any applicable requirements before it can be covered by your plan. You’ll also pay the highest tier cost.

10MG/20MG TABS

10MG/20MG TABS
Not Covered by a 3-Tier Plan
  • QCD

    Note Title
    Quality Care Dosing
    Definition
    To ensure safety and effectiveness, this medication, which is covered through the pharmacy benefit, has quantity and dosage limits that are recommended by the Food and Drug Administration (FDA). Review the Quality Care Dosing Guidelines in the Important Information section to learn more.
  • AAA NON COVERED

    Note Title
    Exceptions To Non Covered Medications
    Definition
    Your doctor may submit a request for an exception. If approved, the medication must still follow any applicable requirements before it can be covered by your plan. You’ll also pay the highest tier cost.

10MG/40MG TABS

10MG/40MG TABS
Not Covered by a 3-Tier Plan
  • QCD

    Note Title
    Quality Care Dosing
    Definition
    To ensure safety and effectiveness, this medication, which is covered through the pharmacy benefit, has quantity and dosage limits that are recommended by the Food and Drug Administration (FDA). Review the Quality Care Dosing Guidelines in the Important Information section to learn more.
  • AAA NON COVERED

    Note Title
    Exceptions To Non Covered Medications
    Definition
    Your doctor may submit a request for an exception. If approved, the medication must still follow any applicable requirements before it can be covered by your plan. You’ll also pay the highest tier cost.

10MG/80MG TABS

10MG/80MG TABS
Not Covered by a 3-Tier Plan
  • QCD

    Note Title
    Quality Care Dosing
    Definition
    To ensure safety and effectiveness, this medication, which is covered through the pharmacy benefit, has quantity and dosage limits that are recommended by the Food and Drug Administration (FDA). Review the Quality Care Dosing Guidelines in the Important Information section to learn more.
  • AAA NON COVERED

    Note Title
    Exceptions To Non Covered Medications
    Definition
    Your doctor may submit a request for an exception. If approved, the medication must still follow any applicable requirements before it can be covered by your plan. You’ll also pay the highest tier cost.

2.5MG/10MG TABS

2.5MG/10MG TABS
Not Covered by a 3-Tier Plan
  • QCD

    Note Title
    Quality Care Dosing
    Definition
    To ensure safety and effectiveness, this medication, which is covered through the pharmacy benefit, has quantity and dosage limits that are recommended by the Food and Drug Administration (FDA). Review the Quality Care Dosing Guidelines in the Important Information section to learn more.
  • AAA NON COVERED

    Note Title
    Exceptions To Non Covered Medications
    Definition
    Your doctor may submit a request for an exception. If approved, the medication must still follow any applicable requirements before it can be covered by your plan. You’ll also pay the highest tier cost.

2.5MG/20MG TABS

2.5MG/20MG TABS
Not Covered by a 3-Tier Plan
  • QCD

    Note Title
    Quality Care Dosing
    Definition
    To ensure safety and effectiveness, this medication, which is covered through the pharmacy benefit, has quantity and dosage limits that are recommended by the Food and Drug Administration (FDA). Review the Quality Care Dosing Guidelines in the Important Information section to learn more.
  • AAA NON COVERED

    Note Title
    Exceptions To Non Covered Medications
    Definition
    Your doctor may submit a request for an exception. If approved, the medication must still follow any applicable requirements before it can be covered by your plan. You’ll also pay the highest tier cost.

2.5MG/40MG TABS

2.5MG/40MG TABS
Not Covered by a 3-Tier Plan
  • QCD

    Note Title
    Quality Care Dosing
    Definition
    To ensure safety and effectiveness, this medication, which is covered through the pharmacy benefit, has quantity and dosage limits that are recommended by the Food and Drug Administration (FDA). Review the Quality Care Dosing Guidelines in the Important Information section to learn more.
  • AAA NON COVERED

    Note Title
    Exceptions To Non Covered Medications
    Definition
    Your doctor may submit a request for an exception. If approved, the medication must still follow any applicable requirements before it can be covered by your plan. You’ll also pay the highest tier cost.

5MG/10MG TABS

5MG/10MG TABS
Not Covered by a 3-Tier Plan
  • QCD

    Note Title
    Quality Care Dosing
    Definition
    To ensure safety and effectiveness, this medication, which is covered through the pharmacy benefit, has quantity and dosage limits that are recommended by the Food and Drug Administration (FDA). Review the Quality Care Dosing Guidelines in the Important Information section to learn more.
  • AAA NON COVERED

    Note Title
    Exceptions To Non Covered Medications
    Definition
    Your doctor may submit a request for an exception. If approved, the medication must still follow any applicable requirements before it can be covered by your plan. You’ll also pay the highest tier cost.
Covered Alternative Medications
  • DILTIAZEM 24HR CD
  • DILTIAZEM HCL
  • DILTIAZEM HCL ER
  • DILTIAZEM HCL ER 12HR
  • AMLODIPINE/ATORVASTATIN
  • AMLODIPINE
  • ATORVASTATIN
  • PRAVASTATIN (Eligible for $0 copay)
  • LOVASTATIN (Eligible for $0 copay)
  • ROSUVASTATIN
  • ROSUVASTATIN (Eligible for $0 copay)
  • ATORVASTATIN (Eligible for $0 copay)
  • SIMVASTATIN (Eligible for $0 copay)
  • VERAPAMIL ER PM
  • VERAPAMIL HCL
  • VERAPAMIL HCL ER
  • FLUVASTATIN (Eligible for $0 copay)
  • FLUVASTATIN XR (Eligible for $0 copay)

What's a tier plan? Back to Top

We sort generic, brand-name, and specialty medications into tiers based on safety, clinical effectiveness, clinical outcomes, cost, and innovation.

Your prescription plan is based on a 2-, 3-, 4-, 5-, or 6-tier plan design. What you pay for medications at the pharmacy is determined by your prescription plan and which tier a medication is in.

To find out how many tiers your prescription plan has, you can do one of the following:

  • Check your plan documents
  • Sign in to your MyBlue account, and review your plan details
  • Call Member Service at the number on your ID card

Check your plan details to find out more about tier coverage.

 Prior Authorization Forms

Massachusetts Standard Form for Hepatitis C Medication Prior Authorization Requests

Massachusetts Standard Form for Medication Prior Authorization Requests

Massachusetts Standard Form for Synagis® Prior Authorization Requests

 Important Information

$9 Generic Medication List

Maintenance Medication List

Over-the-Counter Exclusions

Learn About Your Pharmacy Program

Quality Care Dosing Guidelines

Maintenance Medication List

$9 Generic Medication List

Specialty Pharmacy Contact Information

Specialty Medications and Pharmacy Provider Information

Specialty Network Pharmacy Contact Information

Affordable Care Act (ACA) Covered Medication List

HSA Preventive Medication List

Step Therapy Medications List

Value-Based Benefit Medications List

Quality Care Dosing Guidelines

Step Therapy Medication List

 For Federal Employee Program Members

View the Federal Employee Program Basic Option Formulary

View the Federal Employee Program FEP Blue Focus Formulary

View the Federal Employee Program Standard Option Formulary

 For Medicare Members

Medicare Advantage Medication Look-up

Blue MedicareRx (PDP) Formulary Search

Blue Cross Blue Shield of Massachusetts

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ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia con el idioma. Llame al número de Servicio al Cliente que figura en su tarjeta de identificación llamada 1-800-472-2689 (TTY: 711 ).

ATENÇÃO: Se fala português, são-lhe disponibilizados gratuitamente serviços de assistência de idiomas. Telefone para os Serviços aos Membros, através do número no seu cartão ID chamar  1-800-472-2689 (TTY: 711 ).

ATTENTION : si vous parlez français, des services d’assistance linguistique sont disponibles gratuitement. Appelez le Service adhérents au numéro indiqué sur votre carte d’assuré appel 1-800-472-2689  (TTY : 711 ).

注意:如果您讲中文,我们可向您免费提供语言协助服务。请拨打您 ID  卡上的号码联系会员服务部 通话 1-800-472-2689(TTY  号码:711 )。

ATANSYON: Si ou pale kreyòl ayisyen, sèvis asistans nan lang disponib pou ou gratis. Rele nimewo Sèvis Manm nan ki sou kat Idantitifkasyon w lan (Sèvis pou Malantandan Rele 1-800-472-2689 TTY: 711 ).

LƯU .: Nếu quý vị n.i Tiếng Việt, c.c dịch vụ hỗ trợ ng.n ngữ được cung cấp cho quý vị miễn ph.. Gọi cho Dịch vụ Hội vi.n theo số tr.n thẻ ID của quý vị Cuộc gọi 1-800-472-2689 (TTY: 711 ).

ВНИМАНИЕ: если Вы говорите по-русски, Вы можете воспользоваться бесплатными услугами переводчика. Позвоните в отдел обслуживания клиентов по номеру, указанному в Вашей идентификационной карте вызов  1-800-472-2689 (телетайп: 711 ).

ការជូនដំណឹង៖ ប្រសិនប. ើអ្នកនិយាយភាសា ខ្មែរ សេ  វាជំនួយភាសាឥតគិតថ្លៃ គឺអាចរកបានសម្  រាប ់អ្នក។ សូមទូរស័ព្ទទ ៅផ ្នែ កសេ  វាសមា  ជិកតាមល េខន  ៅល.  ើប ័ណ្ណ សម្  គាល ់ខ្លួ ខ្លួ នរប ស់អ្នក ហៅ  1-800-472-2689 (TTY: 711) ។

ATTENZIONE: se parlate italiano, sono disponibili per voi servizi gratuiti di assistenza linguistica. Chiamate il Servizio per i membri al numero riportato sulla vostra scheda identificativa chiamata  1-800-472-2689 (TTY: 711 ).

참고 : 한국어를 사용하는 경우 언어 지원 서비스를 무료로 사용할 수 있습니다. 신분증에있는 전화 번호 1-800-472-2689 (TTY : 711)로 회원 서비스에 연락하십시오.

ΠΡΟΣΟΧΗ: Εάν μιλάτε Ελληνικά, διατίθενται για σας υπηρεσίες γλωσσικής βοήθειας, δωρεάν. Καλέστε την Υπηρεσία Εξυπηρέτησης Μελών στον αριθμό της κάρτας μέλους σας (ID Card) κλήση 1-800-472-2689 (TTY: 711 ).

UWAGA: Osoby posługujące się językiem polskim mogą bezpłatnie skorzystać z pomocy językowej. Należy zadzwonić do Działu obsługi ubezpieczonych pod numer podany na identyfikatorze zadzwoń 1-800-472-2689 (TTY: 711 ).

ध्यान दें: य दि  आप ह िन् दी बोलते ह ैं, तो भा षा  सहाय  ता  सेवा एँ, आप के लि ए नि :शुल्क  उपलब्ध ह ैं। सदस्य  सेवा ओं को आपके आई.डी. कार  ्ड पर दि ए गए नंबर पर कॉल करें  कॉल 1-800-472-2689 ( टी .टी .वा ई.: 711).

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PAUNAWA: Kung nagsasalita ka ng wikang Tagalog, mayroon kang magagamit na mga libreng serbisyo para sa tulong sa wika. Tawagan ang Mga Serbisyo sa Miyembro sa numerong nasa iyong ID Card tumawag 1-800-472-2689 (TTY: 711 ).

お知らせ:日本語をお話しになる方は無料の言語アシスタンスサービスをご利用いただけます。ID カードに記載の電話番号を使用してメンバーサービスまでお電話ください 呼び出す 1-800-472-2689(TTY: 711 )。

ACHTUNG: Wenn Sie Deutsche sprechen, steht Ihnen kostenlos fremdsprachliche Unterstützung zur Verfügung. Rufen Sie den Mitgliederdienst unter der Nummer auf Ihrer ID-Karte an Anrufen 1-800-472-2689 (TTY: 711 ).

ATTENTION: If you speak a language other than English, language assistance services are available to you free of charge. Call 1-800-472-2689 (TTY: 711).

ຂໍ້ຄວນໃສ່ໃຈ: ຖ້າເຈົ້າເວົ້າພາສາລາວໄດ້, ມີການບໍລິການຊ່ວຍເຫຼືອດ້ານພາສາໃຫ້ທ່ານໂດຍບໍ່ເສຍຄ່າ. ໂທ ຫາ ຝ່າຍບໍລິການສະ ມາ ຊິກທີ່ໝາຍເລກໂທລະສັບຢູ່ໃນບັດຂອງທ່ານ ໂທ 1-800-472-2689 (TTY: 711).

BAA !KOHWIINDZIN DOO&G&: Din4 k’ehj7 y1n7[t’i’go saad bee y1t’i’ 47 t’11j77k’e bee n7k1’a’doowo[go 47 n1’ahoot’i’. D77 bee an7tah7g7 ninaaltsoos bine’d44’ n0omba bik1’7g7ij8’ b44sh bee hod77lnih call 1-800-472-2689 (TTY: 711).