Anthem BCBS: Why their Formulary is Changing

Did you just get a letter from Anthem Blue Cross saying your medication is no longer covered? You aren't alone. In 2025, Anthem—like many major carriers—is performing a "Formulary Cleanup."

This is corporate speak for "moving patients to cheaper drugs to protect our profit margins." It is a massive disruption to your health, but you have a way to fight back.

What is a Formulary?

Think of a formulary as a menu. Anthem decides which drugs they will "subsidize" and which they won't. If your drug is moved to "Tier 4" or removed entirely, your out-of-pocket cost can jump from $30 to $1,000 overnight.

Why the Change?

Anthem is pushing more patients toward "biosimilars"—cheaper imitations of advanced drugs like Humira. While these are often safe, some patients don't respond to them as well as the original. The insurance company is banking on you not appealing the decision.

Bypass the Menu

You don't have to follow Anthem's menu. If they stopped covering your brand-name med, you can use a Patient Assistance Program to get the original drug directly from the manufacturer.

We help Anthem patients bypass these "Formulary Shifts." We ensure you get the exact medicine your doctor ordered for $40 a month, regardless of what the insurance company's "menu" says.

Get your brand-name meds for $40/mo. Check your eligibility now.