CommercialCoverageMedium impact
Upcoming CareFirst Formulary Updates Effective April 1 and May 1, 2022
CareFirst BlueCross BlueShield·Pharmacy
Effective date
Apr 1, 2022
We identified it
Jun 20, 2026
Summary
CareFirst BlueCross BlueShield is implementing quarterly formulary updates affecting prescription drug coverage, with changes to commercial formularies effective April 1, 2022 and Exchange formulary changes effective May 1, 2022. Updates may include drug additions, utilization management changes, tier changes, and medication removals that could impact patient prescription benefits.
Action Required
By April 1, 2022: All staff should review the CareFirst formulary changes summary document to understand which medications are affected for patients with CareFirst prescription benefits. Providers should verify drug coverage and tier status before prescribing, and be prepared to address potential prior authorization requirements or recommend formulary alternatives for affected medications.