Commercial Formulary

Downloadable Documents
Prescription Management Program Overview

A description of the BCBSRI Prescription Management program.

Summary of Most Recent Formulary Changes

A Summary of Recent Formulary Changes

Preferred Drug List (formulary)

List of preferred drugs on formulary

Second-tier Generic Drugs

List of Second-tier Generic Drugs

List of Drug Quantity Limits

List of drugs with quantity limits on plans

Quantity Limit Exception Form

Form used to request a quantity limit exception.

Formulary Exception Process

Overview of medical exception process

Medical Exceptions List

Excluded drugs eligible for the medical exception process

Formulary Exclusions List

List of drugs excluded from the formulary

 

Medical Exceptions

Download guidelines

Download forms

 

Prior Authorization – Non-Specialty Drugs Guidelines

Download guidelines

Download forms

 

Prior Authorization – Specialty Drugs Guidelines

Download guidelines

Download forms

Walgreens Universal Intake Referral Form