State of Michigan

Benefits

State Plan Summary of Benefits

• State Health Plan PPO (for employees hired or rehired before
  April 1, 2010) (PDF)
• New State Health Plan PPO (for employees hired or rehired on or after April 1, 2010) (PDF)
• State Vision Plan (PDF)

Benefit Booklets

• State Vision Plan (PDF)

Prescription Drugs

• Medco Mail Order Pharmacy
  This will take you to the Medco Health Solutions Inc. (your mail-order pharmacy) website. If you are a first-time user on the Medco site, you must register. On the Medco site, click the register now button. Submit the required information, and you are in.
• Formulary Reference Guide (PDF)
  A list of FDA-approved brand-name and generic drugs chosen by the BCBSM Pharmacy and Therapeutics Committee for their safety as well as cost and clinical effectiveness. The guide includes a list of generic, formulary brand and nonformulary brand drugs.
• Mandatory Mail Drug List (PDF)
  A list of prescription drugs that allow members to receive only three fills at a retail pharmacy, after which they must use the Medco mail order program.
• Preferred Drug/Step Therapy List (PDF)
  A list of prescription drugs for which members are required to try the less expensive, often equally effective, drugs before more expensive drugs are approved. If you fill a prescription for one of these medications without getting approval, you'll be responsible for its entire cost.
• Preferred Prescriptions^® Formulary File Sheet (PDF)
  An abbreviated version of the Formulary Reference Guide in an easy-to-print format that you can refer to or take to doctor appointments
• Preferred Prescriptions^® Formulary File Sheet for the State of Michigan (in large font) (PDF)
• Prior Authorization/Step Therapy Drug List (PDF)
  BCBSM monitors the use of certain medications to ensure our members receive the most appropriate and cost-effective drug therapy. Prior authorization for these drugs means that certain clinical criteria must be met before coverage is provided. Also, under step therapy, there are prescription drugs for which members are required to try the less expensive, often equally effective, drugs before more expensive drugs are approved. Your physician can contact our pharmacy help desk to request prior authorization or step therapy approval for these drugs.
• Specialty Drug Guide (PDF)
  An overview and a list of specialty drugs, which are prescribed medications that require special handling, administration or monitoring.