Standard Control with Advanced Control Specialty Formulary

For members with the Standard Control with Advanced Control Specialty Formulary or Standard Control with Advanced Control Specialty Formulary — Focused

The Standard Control with Advanced Control Specialty Formulary and the Standard Control with Advanced Control Specialty Formulary — Focused are available through CVS Caremark^®´, an independent company that administers your pharmacy benefits on behalf of Blue Cross Blue Shield of Massachusetts.

The Standard Control with Advanced Control Specialty Formulary includes coverage for GLP-1 medications, while the Standard Control with Advanced Control with Specialty Formulary — Focused excludes coverage for the subset of prescription GLP-1 and GLP-1/GIP medications that are FDA-approved to treat weight loss and other medical indications (including but not limited to Saxenda, liraglutide (generic Saxenda), Wegovy, and Zepbound). Prescription GLP-1/GLP-1/GIP medications that are FDA-approved to treat diabetes will remain covered. To see which formulary your plan uses, sign in to MyBlue.

If you're eligible for Medicare or already enrolled in a Blue Cross Medicare plan, use the Medicare Medication Lookup tool to see if your prescriptions are covered.

Learn about clinical criteria

If you want information about the critical criteria that determine how we cover medications, treatment, or supplies, visit the Clinical Criteria page.