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2023 Formulary Updates – Provider Notice

Effective January 1, 2023, Horizon Blue Cross Blue Shield of New Jersey will offer two new managed formularies — the Classic Formulary and the Health Insurance Marketplace Formulary. These formularies will be in addition to the Classic Formulary (for Public Sector and Labor Groups), Net Results Formulary and Net Results Enhanced Formulary.

If your patient's health plan is switching to one of these new managed formularies, certain medication(s) that were on your patient’s formulary for 2022 may not be on their formulary in 2023. If you wish to continue to prescribe these non-formulary medication(s) in 2023, you may have to submit a coverage exception form or prior authorization form for your patient(s). These forms are available on MyPrime.com.

You will receive a mailing prior to January 1, 2023, letting you know which of your patients are impacted by these changes. Your impacted patients will also be notified. Please visit www.horizonblue.com/formulary to view additional information about your patient(s)' formulary in November 2022.

Published on: September 30, 2022, 06:47 a.m. ET
Last updated on: September 27, 2022, 06:54 a.m. ET