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CommercialCoverageMedium impact

Upcoming CareFirst Formulary Updates: effective October 1, 2021

CareFirst BlueCross BlueShield·Prior Authorization
Effective date
Oct 1, 2021
We identified it
Jun 20, 2026
Days to comply

Summary

CareFirst BlueCross BlueShield is updating their commercial and exchange formularies effective October 1, 2021, which may include drug additions, utilization management changes, tier changes, and medication removals. A summary of changes is available for provider review to understand how this affects patients with CareFirst prescription benefits.

Action Required

Action needed
Before October 1, 2021: All providers and billing staff must review the CareFirst formulary changes summary available on the provider portal. Update any pre-authorization workflows for affected medications and inform patients of potential drug tier changes that may impact their prescription costs.