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Opioid Reversal Agents: Tier 1 medications including Narcan nasal spray and naloxone

 
 
Document Number:
FFBF25.05f.33
Revision #:
v1.0
Date Published:
1/1/2025
 

 

2025 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Section 5(f). Prescription Drug Benefits
Covered Medications and Supplies

 

Benefits Description
Opioid Reversal Agents: Tier 1 medications including generic naloxone nasal spray and injectable

For more information, consult the FDA guidance at https://www.fda.gov/consumers/consumer-updates/access-naloxone-can-save-life-during-opioid-overdose or call SAMHSA's National Helpline 1-800-662-HELP (4357) or go to https://www.findtreatment.samhsa.gov/.


You Pay
Preferred retail pharmacy: Nothing for the purchase of one 90-day supply per calendar year (no deductible)

Note: Once you have purchased amounts of these medications in a calendar year that are equivalent to a 90-day supply combined, all Tier 1 fills thereafter are subject to the corresponding cost-share.

Non-preferred retail pharmacy: You pay all charges
 

Blue Cross Blue Shield Federal Employee Program
Confidential - Internal Plan use only

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