CommercialCoverageMedium impact
Upcoming CareFirst Formulary Updates Effective October 1, 2024
CareFirst BlueCross BlueShield·Pharmacy
Effective date
Oct 1, 2024
We identified it
Jun 20, 2026
Summary
CareFirst BlueCross BlueShield is implementing quarterly formulary updates effective October 1, 2024, which may include drug additions, utilization management changes, tier changes, and medication removals. These changes will affect prescription benefits for CareFirst members and could impact prior authorization requirements and coverage for medications.
Action Required
By October 1, 2024: Billing team and providers must review the CareFirst formulary updates summary document to identify specific changes affecting their patient population. Update prior authorization workflows and medication lists as needed. Monitor for increased denials or coverage changes for CareFirst prescription benefits starting October 1st.