Plan Changes

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No benefit changes

No benefit changes

No benefit changes

AY2024: 8/1/2024 – 7/31/2025AY2025: 8/1/2025 – 7/31/2026
Chronic Condition Management Medication ListBCBSMA has designated certain medications be covered with limited out-of-pocket liability for the following chronic conditions: diabetes, asthma, heart conditions.

If filling one of these medications on this list, the member will pay $0 for generic medications, and no more than $25 for a 30-day supply for brand-name medications.

Review Program Information Sheet
Weight Loss MedicationsBCBSMA has added a new dispensing limit of 30 days per fill for GLP-1 medications, Saxenda, Wegovy, and Zepbound.

Blue Cross Blue Shield of MA usually reviews its standard prescription drug formulary for most changes on July 1 and January 1. Effective July 1, 2025, BCBSMA has updated its formulary (list of covered medications) for medical plans with pharmacy benefits. As part of this update, certain medications may:

  • No longer be covered
  • Have new quantity or dosing limits
  • Switch copayment tiers
  • Require prior authorization and/or step therapy
  • No longer be covered under the pharmacy benefit and will only be covered under the medical benefit
  • Changes to medical policy
  • Changes to participating specialty medications in the PillarRx program

Members impacted by any of these changes will receive a letter from BCBSMA.