Drugs, drug plans and vaccines

Medicare Advantage-prescription drug program and Prescription Blue^SM

Medicare Part D prescription coverage may be included with a member's Medicare Plus Blue coverage (known as a Medicare Advantage prescription drug plan), or the member may have purchased Prescription Blue separately.

 

Prescription Blue, is a freestanding, ancillary or stand-alone, Medicare Part D prescription drug program offered by BCBSM. Check the member ID card and summary of benefits for more member information.

 

Here are a few handy prescription drug resources:

• Drug formulary (PDF)
• Prior Authorization / Step Therapy Program (PDF)
• Determination Request Form (PDF)
• Medicare Part D Payer Sheet (PDF)

Vaccine roster billing information and forms

Flu and pneumonia vaccines are covered under Medicare Part B benefits and shouldn't be billed to the member's Medicare Part D plan.

• Roster Billing for Influenza and Pneumococcal Vaccines on the CMS-1450 (UB-04) (PDF)
• Roster Billing for Influenza and Pneumococcal Vaccines on the CMS-1500 Claim (PDF)
• BCBSM Medicare Advantage Plan Influenza A (H1N1) Immunization Roster (PDF)
• BCBSM Medicare Advantage Plan Influenza Immunization Roster (PDF)
• BCBSM Medicare Advantage Plan Pneumococcal Polysaccharide Virus (PPV) Immunization Roster (PDF)

Other vaccine coverage

Coverage for other vaccines may fall under Part A, Part B or Part D (PDF).