Anthem Blue Cross and Blue Shield Coverage for

12 Plans

Medicare - MA-PD

$$$$$
Preferred
Quantity Limit

Commercial - Employer

$$$$$
Non-preferred
Quantity Limit

Commercial - HMO

$$$$$
Non-preferred
Quantity Limit

Commercial - PPO

$$$$$
Non-preferred
Quantity Limit

Commercial - POS

$$$$$
Non-preferred
Quantity Limit

Managed Medicaid - HMO - Medicaid

$$$$$
Preferred
Quantity Limit

Health Exchange - PPO-HIX

$$$$$
Non-preferred
PA requirements
Step therapies
Quantity Limit

Health Exchange - HDHP-HIX

$$$$$
Non-preferred
PA requirements
Step therapies
Quantity Limit

Health Exchange - HMO-HIX

$$$$$
Non-preferred
PA requirements
Step therapies
Quantity Limit

Commercial - Other Insurer

$$$$$
Non-preferred
PA requirements
Quantity Limit

Medicare - PDP

$$$$$
Non-preferred
Quantity Limit

Health Exchange - POS-HIX

$$$$$
Non-preferred
PA requirements
Step therapies
Quantity Limit