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This brochure version is for internal use only.
 
 
2023 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Section 5(f). Prescription Drug Benefits
 
Benefits Description
Opioid Reversal Agents: Tier 1 medications limited to generic naloxone nasal spray and injectable


You Pay
Preferred retail and overseas retail pharmacy: Nothing for the purchase of one 90-day supply per calendar year (no deductible)

Note: Once you have purchased amounts of these medications in a calendar year that are equivalent to a 90-day supply combined, all Tier 1 fills thereafter are subject to the corresponding cost-share.

Non-preferred retail pharmacy: You pay all charges