Prescription Drug Frequently Asked Questions (FAQ) - CareFirst BlueCross BlueShield
CareFirst BlueCross BlueShield  
About Us Careers Contact Us Glossary Media Center Search the CareFirst Site
Prescription Drugs
Drug Search Order Drugs Online Pharmacy Locator Prescription Drug Forms Common Questions
CareFirst.com Rx Drugs FAQs - Rx Drug Program
Frequently Asked Questions - Prescription Drug Program

The Frequently Asked Questions below refer to the Prescription Drug Program. If this is not your plan, please return to the FAQ Home Page.

3-Tier Prescription Drug Program
General Information
Generic Substitution
Mail Order Prescriptions
Maintenance Medications
Preferred Drug List/Formulary
Prescription Drug Coverage
Prior Authorization
Quantity Limitations
Travel Coverage


3-Tier Prescription Drug Program
What is the 3-Tier Prescription Drug Program?
Do I have to use a generic drug if it is available?
What do I pay if the entire cost of my drug is less than my copay or coinsurance minimum amount?
Are all available generic drugs included as Tier 1 drugs on the preferred drug list?
Can I appeal a 3-Tier cost payment?

General Information
Who is Argus Health Systems, Inc. (Argus)?
Do I have a choice of pharmacies?
Do I have an annual maximum as part of my drug plan?
How do I use my retail prescription drug card benefits?
Who do I contact if I have questions about my medication?
How do I obtain a copy of my Certificate of Coverage?

Generic Substitution
What is generic substitution and how does it work?

Mail Order Prescriptions
How do I get prescriptions filled through a mail order pharmacy?

Maintenance Medications
What is a maintenance drug?

Preferred Drug List/Formulary
What is a preferred drug list (formulary)?
How do drugs get on the preferred drug list?
How can I find out if my drug is on the preferred drug list?
Which brand name drugs are not on the preferred drug list formulary?
How does the preferred drug list (formulary) help me?
Do my benefits provide coverage for preferred drugs only?
Why does the preferred drug list change?
What is the difference between a preferred brand name drug (Tier 2) and a non-preferred brand name (Tier 3) drug?

Prescription Drug Coverage
What is a generic drug?
What is a brand name drug?
What is an Over the Counter (OTC) drug?
What types of drugs are not covered by my benefits?
Does my prescription drug benefit cover compound medications?
How are Allergy Serums covered?

Prior Authorization
What is Prior Authorization (PA)?
How does Prior Authorization (PA) work?
How do I know if my drug requires a Prior Authorization (PA)?
Does my doctor need to get a Prior Authorization (PA) each time my prescription is filled?
What can I do if I am at the pharmacy and discover my medication requires a Prior Authorization (PA) but none was requested in advance?

Quantity Limitations
What is a Quantity Limit?
How can I get an exception to a quantity limit?

Travel Coverage
If I am going out of the country for an extended period of time, how do I request the extra supply of drugs I will need?

Solution Center
Look up ...
Drug-to-Drug Interactions
Drug Dictionary
Learn About Generic Drugs
Information about Medi-CareFirst's Part D Plans (Blue Rx)
How to Use Your Drug Plan
Prior Authorization
<empty> Maintenance Medications
<empty> Quantity Limits
<empty> Preferred Drug List
(Printable Version)
Health & Wellness -
My Care First (En Español)
News & Updates

Accusure Insulin Syringes Recalled

Azmacort® Inhalation Aerosol Soon Discontinued

Changes to the Preferred Drug List

Nutritional Supplements and Over-the-Counter FDA Safety Information

Get monthly health news by e-mail

Vitality Member Newsletter

Latest News & Archives
Serving Maryland, the District of Columbia and portions of Virginia. CareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc. CareFirst BlueChoice, Inc., an affiliate company, also offers health benefit products and services on this site.

CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. are independent licensees of the Blue Cross and Blue Shield Association.

® Registered trademark of the Blue Cross and Blue Shield Association. ®' Registered trademark of CareFirst of Maryland, Inc.