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Medication Lookup

The results below have been sorted using a 2-tier plan. For the most accurate search results, check your plan details and choose another tier plan from the drop-down menu near the search bar.

NEUPOGEN
THERAPEUTIC CLASS: Granulocyte Colony-Stimulating Factors (G-CSF)
Select a strength to see details

300MCG/ML VIAL

300MCG/ML VIAL
Not Covered by a 3-Tier Plan
Learn more about tiers.
  • Note Title
    Quality Care Dosing
    Definition
    To ensure safety and effectiveness, this medication, which is covered through the pharmacy benefit, has quantity and dosage limits that are recommended by the Food and Drug Administration (FDA). Review the Quality Care Dosing Guidelines in the Important Information section to learn more.
  • Note Title
    Not Available Through Mail Service
    Definition
    This medication is not available through the mail service pharmacy
  • Note Title
    Requires Specialty Pharmacy
    Definition
    This medication will only be covered through the pharmacy benefit when purchased through a specialty pharmacy that participates in our network. To find a specialty pharmacy, visit Specialty Network Pharmacy Contact Information in the Specialty Pharmacy section.
  • Note Title
    Exceptions To Non Covered Medications
    Definition
    Your doctor may submit a request for an exception. If approved, the medication must still follow any applicable requirements before it can be covered by your plan. You’ll also pay the highest tier cost.
  • Note Title
    Not Covered By Blue Cross for Medicare Supplemental members
    Definition
    Medicare Supplemental Plan Members: Since this medication is covered by Medicare as a medical benefit, it is excluded from your pharmacy coverage. You will need to verify coverage from Medicare directly.
  • Note Title
    Prior Authorization Required
    Definition
    This medication requires your doctor to obtain prior authorization from us in order to be covered through the pharmacy benefit.
  • Note Title
    Prior Authorization Required
    Definition
    This medication requires your doctor to obtain prior authorization from us in order to be covered through the medical benefit.

480MCG/1.6ML SOLN

480MCG/1.6ML SOLN
Not Covered by a 3-Tier Plan
Learn more about tiers.
  • Note Title
    Quality Care Dosing
    Definition
    To ensure safety and effectiveness, this medication, which is covered through the pharmacy benefit, has quantity and dosage limits that are recommended by the Food and Drug Administration (FDA). Review the Quality Care Dosing Guidelines in the Important Information section to learn more.
  • Note Title
    Not Available Through Mail Service
    Definition
    This medication is not available through the mail service pharmacy
  • Note Title
    Requires Specialty Pharmacy
    Definition
    This medication will only be covered through the pharmacy benefit when purchased through a specialty pharmacy that participates in our network. To find a specialty pharmacy, visit Specialty Network Pharmacy Contact Information in the Specialty Pharmacy section.
  • Note Title
    Exceptions To Non Covered Medications
    Definition
    Your doctor may submit a request for an exception. If approved, the medication must still follow any applicable requirements before it can be covered by your plan. You’ll also pay the highest tier cost.
  • Note Title
    Not Covered By Blue Cross for Medicare Supplemental members
    Definition
    Medicare Supplemental Plan Members: Since this medication is covered by Medicare as a medical benefit, it is excluded from your pharmacy coverage. You will need to verify coverage from Medicare directly.
  • Note Title
    Prior Authorization Required
    Definition
    This medication requires your doctor to obtain prior authorization from us in order to be covered through the pharmacy benefit.
  • Note Title
    Prior Authorization Required
    Definition
    This medication requires your doctor to obtain prior authorization from us in order to be covered through the medical benefit.

300MCG/0.5ML SYRINGE

300MCG/0.5ML SYRINGE
Not Covered by a 3-Tier Plan
Learn more about tiers.
  • Note Title
    Quality Care Dosing
    Definition
    To ensure safety and effectiveness, this medication, which is covered through the pharmacy benefit, has quantity and dosage limits that are recommended by the Food and Drug Administration (FDA). Review the Quality Care Dosing Guidelines in the Important Information section to learn more.
  • Note Title
    Not Available Through Mail Service
    Definition
    This medication is not available through the mail service pharmacy
  • Note Title
    Requires Specialty Pharmacy
    Definition
    This medication will only be covered through the pharmacy benefit when purchased through a specialty pharmacy that participates in our network. To find a specialty pharmacy, visit Specialty Network Pharmacy Contact Information in the Specialty Pharmacy section.
  • Note Title
    Exceptions To Non Covered Medications
    Definition
    Your doctor may submit a request for an exception. If approved, the medication must still follow any applicable requirements before it can be covered by your plan. You’ll also pay the highest tier cost.
  • Note Title
    Not Covered By Blue Cross for Medicare Supplemental members
    Definition
    Medicare Supplemental Plan Members: Since this medication is covered by Medicare as a medical benefit, it is excluded from your pharmacy coverage. You will need to verify coverage from Medicare directly.
  • Note Title
    Prior Authorization Required
    Definition
    This medication requires your doctor to obtain prior authorization from us in order to be covered through the pharmacy benefit.
  • Note Title
    Prior Authorization Required
    Definition
    This medication requires your doctor to obtain prior authorization from us in order to be covered through the medical benefit.

480MCG/0.8ML SYRINGE

480MCG/0.8ML SYRINGE
Not Covered by a 3-Tier Plan
Learn more about tiers.
  • Note Title
    Quality Care Dosing
    Definition
    To ensure safety and effectiveness, this medication, which is covered through the pharmacy benefit, has quantity and dosage limits that are recommended by the Food and Drug Administration (FDA). Review the Quality Care Dosing Guidelines in the Important Information section to learn more.
  • Note Title
    Not Available Through Mail Service
    Definition
    This medication is not available through the mail service pharmacy
  • Note Title
    Requires Specialty Pharmacy
    Definition
    This medication will only be covered through the pharmacy benefit when purchased through a specialty pharmacy that participates in our network. To find a specialty pharmacy, visit Specialty Network Pharmacy Contact Information in the Specialty Pharmacy section.
  • Note Title
    Exceptions To Non Covered Medications
    Definition
    Your doctor may submit a request for an exception. If approved, the medication must still follow any applicable requirements before it can be covered by your plan. You’ll also pay the highest tier cost.
  • Note Title
    Not Covered By Blue Cross for Medicare Supplemental members
    Definition
    Medicare Supplemental Plan Members: Since this medication is covered by Medicare as a medical benefit, it is excluded from your pharmacy coverage. You will need to verify coverage from Medicare directly.
  • Note Title
    Prior Authorization Required
    Definition
    This medication requires your doctor to obtain prior authorization from us in order to be covered through the pharmacy benefit.
  • Note Title
    Prior Authorization Required
    Definition
    This medication requires your doctor to obtain prior authorization from us in order to be covered through the medical benefit.

 Prior Authorization Forms

Massachusetts Standard Form for Hepatitis-C Medication Prior Authorization Requests

Massachusetts Standard Form for Medication Prior Authorization Requests

Massachusetts Standard Form for Synagis® Medication Prior Authorization Requests

 Important Information

Affordable Care Act (ACA) Medication List

Maintenance Medication List

Medical Benefit Prior Authorization Medication List

Over-the-Counter Exclusion Medication List

Quality Care Dosing Guidelines

Step Therapy Medication List

Learn About Your Pharmacy Program

Learn About Tiers

Learn About Your Pharmacy Program

$0 Copay Medication List

Affordable Care Act (ACA) Medication List

Cost-Share Assistance Program Medication List

Health Savings Account (HSA) Preventive Medication List

Lower-Cost, Brand-Name Insulins Medication List

Maintenance Medication List

Medical Benefit Prior Authorization Medication List

No-Cost Generic Medications List

Over-the-Counter Exclusion Medication List

Quality Care Dosing Guidelines

Step Therapy Medication List

 Specialty Pharmacy

Specialty Pharmacy Medication List

5-Tier Specialty Pharmacy Medication List

6-Tier Specialty Pharmacy Medication List

Specialty Network Pharmacy Contact Information

Specialty Network Pharmacy Contact Information

 Alternatives to Opioids

Covered Pain Management Medication List

Alternatives to Opioid-Based Medications

 For Federal Employee Program Members

Visit fepblue.org to search the formularies

 Eligible Medicare Members

Search a Medicare Formulary

Covered Alternative Medications