Prescription

New Prescription Formulary

A new Preferred Value Formulary will be implemented starting January 1, 2027

The prescription drug benefit will be changing to the Excellus BCBS Preferred Value Formulary. This change could mean a medication may no longer be covered or it may move to a different tier which could result in a higher copayment.

This change affects coverage for GLP-1’s for weight loss. Wegovy, Zepbound and Saxenda will no longer be on our list of covered drugs. However, If a member is currently taking a GLP-1 for weight management they will be allowed to continue therapy as long as they maintain or improve from their initial weight loss of 5% and continue to be enrolled in a comprehensive weight management program.

Members who will be affected by this change will receive a letter from Excellus BCBS. Members who are currently on a medication that is affected by this change will have the option, in most cases, to be grandfathered.

Prescription copayments are remaining the same for all plans.

Prescription Mail Order Benefit Save Time and Saves Money!

Having your prescriptions delivered to your door not only saves you time, but it also saves you money!

It can be very beneficial for you to consider utilizing the prescription mail order benefit available on our plan. With our mail order benefit, you pay only 2 copayments for a 90-day supply. Your savings for a Tier 3 medication can range from $280 up to $360 annually.

There are two mail order provider options:

Wegmans – 1-800-586-6910

Express Scripts – 1-855-315-5220