Anthem, now operating under the parent company Elevance Health, is one of the largest BCBS affiliates and uses IngenioRx as its pharmacy benefits manager. Anthem's 2026 formulary applies across its commercial, Medicare, and Medicaid plans, though specific drug lists vary by plan type and state. Anthem has been expanding its value-based formulary options that prioritize generics and biosimilars.
Key Facts
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Coverage varies by plan. Use our formulary checker tool to look up your exact copay and restrictions.
Open Formulary CheckerFrequently Asked Questions
Anthem is a BCBS licensee operating in 14 states. It uses the Blue Cross and Blue Shield brand names in most of its markets. While it follows some BCBS national standards, its formulary is independently managed by IngenioRx. Other BCBS companies in other states have their own separate formularies.
Your doctor can submit a formulary exception request through the Availity provider portal or by fax. You will need clinical documentation explaining why the requested drug is medically necessary and why formulary alternatives are not appropriate. Anthem responds within 72 hours for standard requests.
Coverage varies by plan. Some Anthem employer plans are beginning to cover FDA-approved weight loss GLP-1s like Wegovy and Zepbound with prior authorization and medical necessity documentation. Medicare and most individual market plans generally do not cover weight loss drugs under current rules.
Related Resources
- Blue Cross Blue Shield Formulary 2026
- Aetna Formulary 2026
- UnitedHealthcare Formulary 2026
- Wegovy cash price comparison on RxGrab
- Zepbound cash price comparison on RxGrab
- Eliquis cash price comparison on RxGrab
- Humira cash price comparison on RxGrab
- Atorvastatin cash price comparison on RxGrab
- Drug interaction checker tool
- Patient assistance program finder
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