CommercialCoverageMedium impact
Upcoming CareFirst Formulary Updates Effective April 1, 2023 and May 1, 2023
CareFirst BlueCross BlueShield·Pharmacy
Effective date
Apr 1, 2023
We identified it
Jun 20, 2026
Summary
CareFirst BlueCross BlueShield is implementing formulary updates effective April 1, 2023 for Formularies 1-4 and May 1, 2023 for Exchange Formulary. These changes may include drug additions, tier changes, utilization management modifications, and medication removals that will affect prescription coverage for CareFirst patients.
Action Required
By March 31, 2023: Clinical staff should review the CareFirst formulary update summary document to identify affected medications for their patients. Update prescription protocols and inform providers of any tier changes or newly restricted medications. Be prepared to submit prior authorizations or switch patients to preferred alternatives for medications removed from formulary.