CommercialCoverageMedium impact
Upcoming CareFirst Formulary Updates Effective October 1, 2022
CareFirst BlueCross BlueShield·Pharmacy
Effective date
Oct 1, 2022
We identified it
Jun 20, 2026
Summary
CareFirst BlueCross BlueShield is implementing formulary updates effective October 1, 2022, which may include drug additions, tier changes, utilization management changes, and medication removals. These changes will affect prescription benefits for CareFirst members and could impact provider reimbursement in value-based contracts.
Action Required
Before October 1, 2022: Clinical staff should review the CareFirst formulary update summary (link provided in policy) to understand specific drug changes. Update prescribing protocols and patient communication processes for affected medications. Monitor for potential prior authorization requirements or tier changes that may affect patient costs and treatment plans.