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Pharmacy and prescription drugs

Beginning April 1, 2023, all Medicaid members enrolled in Empire BlueCross BlueShield HealthPlus will receive their prescription drugs through NYRx, the Medicaid Pharmacy Program. 

Information about the transition of the pharmacy benefit from Empire to NYRx, the Medicaid Pharmacy Program can be found HERE

General information about NYRx, the Medicaid Pharmacy Program can be found HERE along with information for Members and Providers.

New York Department of State Logo

For Child Health Plus and Essential Plan members, we offer a wide range of prescription and over-the-counter (OTC) drugs, home delivery, and more. We work with CarelonRx to provide these benefits.

To find a pharmacy near you, use our pharmacy locator tool.

Find a pharmacy

Have your medicines mailed to you

Did you know you have the option to have maintenance prescription drugs delivered to your home through the mail? You may be able to receive a 90-day supply right to your door. Have a copay? A 90-day supply through home-delivery costs the same as a 30-day supply from a retail pharmacy.

Why sign up for mail-order prescriptions?

  • Safety: You don’t have to leave home — your prescriptions are sent right to you.
  • Convenience: Easily order refills by phone or online — and with 90-day supplies, you refill less often.
  • Savings: If you have a copay, you only pay the 30-day amount for your 90-day supply.

Use this form to set up home delivery for your prescription.

Log in to your account


Copays are a set dollar amount you pay for a covered service, like getting a prescription filled.

There may be copays for your prescriptions. Check your member handbook to see if your plan has copays.

Starting April 1, 2023, your prescriptions will not be covered by Empire. They will be covered by Medicaid NYRx, the Medicaid pharmacy program.

There are no copays for covered drugs.

Starting April 1, 2023, your prescriptions will not be covered by Empire. They will be covered by Medicaid NYRx, the Medicaid pharmacy program.

Managed Long-Term Care (MLTC and MAP) members

Your pharmacy benefits are not covered through Empire. You either get these services through Medicare or through fee-for-service Medicaid.

Learn more about MLTC
Learn more about MAP

Find out if your prescription is covered

Preferred Drug List (PDL)

Empire has a list of preferred drugs chosen for their quality and effectiveness. It’s called a Preferred Drug List (PDL).

Many of the drugs listed on the PDL do not need preapproval. Drugs not listed on the PDL always require preapproval. This means your doctor must get approval from us before they can write a prescription for the drug. Go to the preapprovals section below for more information.

The PDL can change at any time. Please check back for updates.

Searchable formulary

The formulary is a list of all brand-name and generic drugs available in your plan. It lists both drugs found on the PDL and others not listed on the PDL. Use our searchable formulary to search for drugs by:

  • Typing the name of the drug in the search box.
  • Using the A–Z list to search by the first letter of the drug name.
  • Clicking the therapeutic class of the drug.

Essential Plan members

Essential Plan formulary

Medicaid members

NYRx Medicaid formulary

CHPlus members

CHPlus formulary

HARP members

NYRx HARP formulary
Don’t see it listed?

If you need to take a drug not listed in the formulary, you may request an exception at submitmyexceptionreq@empireblue.com. You’ll be asked to supply a reason why it should be covered, such as an allergic reaction to a drug.

Managing your prescription

Prescription Drug Reimbursement Form

Specialty pharmacy

Get your specialty medications

If you have a specialty condition, you have the option to use CarelonRx Specialty Pharmacy for your specialty medication needs. We partner with CarelonRx Specialty and other pharmacies to meet all your specialty medication needs.

Learn more about specialty pharmacy


Some medicines need a preapproval, or an OK, from us before your doctor can prescribe them. Drugs that require preapproval will be listed with PA next to the drug name. For those medicines, your doctor must get preapproval before you can fill your prescription. Your doctor can get this by calling our Pharmacy department.

Drugs that require preapproval include those that:

  • Have high side-effect potential
  • Should be prescribed only for specific usage
  • Have high misuse or abuse potential
  • May cost more than other preferred drugs

The preapproval process helps us make sure you’re taking medicines safely and correctly.

Other times you may need preapproval are:

  • When requesting a higher dosage than recommended
  • When requesting a brand-name drug that already has an FDA-approved generic version
  • When the drug is part of a step therapy treatment plan. Step therapy means trying less expensive options before "stepping up" to drugs that cost more.
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Need to talk with a nurse?

Whether it’s 3 a.m. or a Sunday afternoon, health issues happen at the most inconvenient times. Our 24/7 NurseLine gives you fast, free medical advice anytime, day or night. Call 1-800-300-8181 (TTY 711).