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Pharmacy Information

Select the appropriate option below:

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Employer Sponsored Plan with a Customized Formulary

Select this option for group numbers 029653, 029737, 029778, 042000, 042001, 042002, 042003, 042004, 042005, 042006, 042007, 042008. Group numbers can be found on the member's Blue Cross Blue Shield of Arizona's identification card.
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Affordable Care Act (ACA) Formulary

Select this option if the member’s medical plan is ACA compliant. Plans would include the following: Portfolio, SimpleHealth, CopayComplete, EverydayHealth, Essential and FitRewards.
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Other

Select this option if the member’s health plan does not fall into the above categories.
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