Breadcrumb

senior enjoying weather

Formulary & Tier Exceptions

You and your doctor can ask Horizon BCBSNJ to make an exception to cover a drug. If your doctor says that you have medical reasons to justify an exception, your doctor can help you request an exception. For example, you can ask the Horizon BCBSNJ to cover a drug even though it is not on your plan’s drug list, or you can ask the Horizon BCBSNJ to make an exception and cover the drug without restrictions.

Your doctor must submit a formulary exception or tier exception request form for approval. If the request is not approved by Horizon BCBSNJ, you can still purchase the medicine at your own expense.

Find In-Network Doctors

If you need to find a new doctor who participates in one of our networks, our Doctor & Hospital finder makes it easy to find a health care professional who matches your needs.

Find In-Network Pharmacies

Search from more than 66,000 in-network pharmacies at Prime Therapeutics.

Find Covered Prescription Drugs

Find formulary drugs, prior authorization, and step therapy at Prime Therapeutics.