Preventive Medications Covered 1 by HSA-Qualified “Saver” Plans The medications on this list are commonly prescribed to help you stay healthy by preventing complications or secondary conditions. Depending on your plan, you may not be required to pay the deductible for some of the medications. In some cases, your employer may also exempt the copayment or co-insurance. Check your benefit materials for details. 2 This isn’t a complete list of covered medications, and inclusion on this list doesn’t guarantee coverage. You must have a valid prescription from a licensed health provider to receive coverage for these medications. Some medications may also be subject to pharmacy management programs, such as step therapy, prior authorization, or quality care dosing, or have other coverage requirements. NOTE: Some medications on this list may be considered non-covered, including new medications under review by Blue Cross. Your doctor may request an exception for a non-covered medication when 3 medically necessary. Learn more about your coverage For more information about coverage for these medications, sign in to MyBlue at bluecrossma.org then go to Medication Lookup Tool under My Medications. If you're not a member, you can get more information by visiting bluecrossma.org/medication. 1. Blue Cross Blue Shield of Massachusetts plans that are HSA-qualified include the term “Saver” in the plan name. For example: Blue Care Elect Saver or HMO Blue New England Saver $2,000. 2. Not all medications listed are covered by all prescription plans. Check your benefit materials for details. 3. If approved, you’d pay the highest-tier cost. 2