Contact Us
Phone: 610-526-5261

Human Resources
101 N. Merion Ave.
Bryn Mawr College
Bryn Mawr, PA 19010-2899

Mapping Address:
140 Morris Ave.
Bryn Mawr, PA 19010-2899

Fax: 610-526-7478
(Recruitment, General)
Fax: 610-526-7850
(Director, Benefits, HRIS)

Independence Blue Cross Select Drug Program - Formulary

The formulary is a list of covered drugs and their places in the payment structure that is maintained by Independence Blue Cross. In general, a brand name prescription will be included on the formulary if no generic drug is available. In certain cases, a brand name prescription will still be covered even if a generic drug is available. Alternatively, a brand name drug with no generic equivalent may be excluded from the formulary because an alternative medication is available on the formulary.

The list of covered drugs is regularly updated based on new brand name and new generic drug availability. Please note that most non-formulary drugs are expensive, and the co-payment will represent only a fraction of the full cost. In almost all circumstances, patients will only have to pay the non-formulary co-payment when a brand name drug is elected over available alternatives. If no alternatives are available, a patient or his/her doctor does have the right to file an appeal.

The Select Drug Program includes a mail-order service for up to a 90-day supply on certain maintenance medications. The mail-order co-payment for both Keystone and Personal Choice is two times the standard co-payment. Coverage for injectable drugs is available, but generally only when considered medically necessary by Independence Blue Cross. Injectable fertility drugs are not covered. Also, please note that payment is limited to 30% if you use a pharmacy that does not participate in the PAID program.

More information about the Select Drug Program, including the latest version of the formulary and details on the Mail Order Program and Prior Authorizations, is available on the Independence Blue Cross web site.

Formulary Payment Structure

 
Generic
Brand Name Formulary
Brand Name Non-Formulary
Personal Choice
$20
$40
$60
Keystone
$15
$35
$50