OSP News

Upcoming Drug Formulary Changes for Blue Cross Blue Shield of Michigan and Blue Care Network Medicare Advantage Part D Plans

Posted: 11/01/2024

In 2025, Blue Cross Blue Shield of Michigan and Blue Care Network will make significant changes to their Medicare Advantage and Part D drug formularies. These updates, intended to comply with federal guidelines and Part D redesign, will lead to some drugs being removed, moved to higher cost tiers, or requiring prior authorization, step therapy, or quantity limits. Consequently, healthcare providers may need to prescribe alternative medications, although most medications have suitable replacements, and most members are not expected to face higher out-of-pocket costs.

Letters explaining these changes have been sent to affected members and providers, including details on specific patients impacted. Additionally, BCBS has published the 2025 formularies online and developed a "Formulary Alternative Finder" tool on the Availity portal to help providers identify alternative medications. 

Click here to read the article posted in The Record.

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