{"id":11760,"date":"2025-11-17T10:46:59","date_gmt":"2025-11-17T15:46:59","guid":{"rendered":"https:\/\/www.bluekc.com\/blueprint\/?p=11760"},"modified":"2025-11-17T10:46:59","modified_gmt":"2025-11-17T15:46:59","slug":"prescription-drug-list-updates-effective-january-1-2026","status":"publish","type":"post","link":"https:\/\/www.bluekc.com\/blueprint\/agents\/employer-resources\/prescription-drug-list-updates-effective-january-1-2026\/","title":{"rendered":"Prescription drug list updates effective January 1, 2026"},"content":{"rendered":"\n<p>The Blue Cross and Blue Shield of Kansas City (Blue KC) Medical and Pharmacy Management Committee has completed its quarterly review of the prescription drug lists (PDL) and other pharmacy programs for drug safety, effectiveness, clinical outcomes, and cost.<\/p>\n\n\n\n<p>The following groups will see PDL updates, effective January 1, 2026.<\/p>\n\n\n\n<p><strong>Large employer groups (100+)<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li class=\"has-darker-blue-color has-text-color has-link-color wp-elements-165af35334305827e65eea3ddacd3bbd\"><a href=\"https:\/\/www.bluekc.com\/blueprint\/wp-content\/uploads\/sites\/3\/2025\/11\/FINAL_1.1.26_PDL_Select-Updates.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Select PDL\u00a0routine updates<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.bluekc.com\/blueprint\/wp-content\/uploads\/sites\/3\/2025\/11\/FINAL_1.1.26_PDL_Premium-Updates.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Premium PDL\u00a0routine updates<\/a><\/li>\n<\/ul>\n\n\n\n<p><strong>Non-ACA small employer groups (2-99, including level-funded ASO)<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/www.bluekc.com\/blueprint\/wp-content\/uploads\/sites\/3\/2025\/11\/FINAL_1.1.26_PDL_Premium-Updates.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Premium PDL\u00a0routine updates<\/a><\/li>\n<\/ul>\n\n\n\n<p><strong>ACA small employer groups<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/www.bluekc.com\/blueprint\/wp-content\/uploads\/sites\/3\/2025\/11\/FINAL_1.1.26_PDL_EHB-Updates.pdf\" target=\"_blank\" rel=\"noreferrer noopener\">Essential Health Benefits PDL\u00a0routine updates<\/a><\/li>\n<\/ul>\n\n\n\n<h2 class=\"wp-block-heading\"><strong>Group and member communications<\/strong><\/h2>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Impacted employer groups\u00a0<\/strong>will receive either a letter or email the weeks of November 23 or November 30. <a href=\"https:\/\/www.bluekc.com\/blueprint\/wp-content\/uploads\/sites\/3\/2025\/11\/FINAL_1.1.26_PDL_Updates_Email_Ltr_Content.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>Read<\/strong>\u00a0<\/a>the email and letter content.<\/li>\n\n\n\n<li><strong>Impacted members<\/strong>\u00a0will receive a\u00a0<a href=\"https:\/\/www.bluekc.com\/blueprint\/wp-content\/uploads\/sites\/3\/2024\/11\/PDL_SampleMemberLetter.pdf\" target=\"_blank\" rel=\"noreferrer noopener\"><strong>letter<\/strong><\/a>\u00a0appropriate to their prescription change by December 1.<\/li>\n<\/ul>\n\n\n\n<p>If you have questions, please contact your Blue KC representative.<\/p>\n\n\n\n<p><a id=\"_msocom_1\"><\/a><\/p>\n\r\n\t\t\t<div id=\"daexthefu-container\"\r\n\t\t\t\tclass=\"daexthefu-container daexthefu-layout-side-by-side daexthefu-alignment-left\"\r\n\t\t\t\tdata-post-id=\"11760\">\r\n\r\n\t\t\t\t<div class=\"daexthefu-feedback\">\r\n\t\t\t\t\t<div class=\"daexthefu-text\">\r\n\t\t\t\t\t\t<h3 class=\"daexthefu-title\">Was this helpful?<\/h3>\r\n\t\t\t\t\t<\/div>\r\n\t\t\t\t\t<div class=\"daexthefu-buttons-container\">\r\n\t\t\t\t\t\t<div class=\"daexthefu-buttons\">\r\n\t\t\t\t\t\t\t\r\n\t\t\t<div class=\"daexthefu-yes daexthefu-button daexthefu-button-type-icon\" data-value=\"1\">\r\n\t\t\t\t\r\n                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class=\"daexthefu-successful-submission-text\">Thanks for your feedback!<\/div>\r\n\r\n\t\t\t<\/div>\r\n\r\n\t\t\t","protected":false},"excerpt":{"rendered":"<p>The Blue Cross and Blue Shield of Kansas City (Blue KC) Medical and Pharmacy Management Committee has completed its quarterly review of the prescription drug lists (PDL) and other pharmacy programs for drug safety, effectiveness, clinical outcomes, and cost. The&#8230;<\/p>\n","protected":false},"author":26,"featured_media":11766,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_helpful_status":1,"_analytify_skip_tracking":false,"footnotes":""},"categories":[2,7,11],"tags":[57],"post-on-community-impact":[],"class_list":["post-11760","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-agents","category-gated-agent","category-employer-resources","tag-agents-employer-group"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v26.1.1 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Prescription drug list updates effective January 1, 2026 - The Blueprint<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.bluekc.com\/blueprint\/agents\/prescription-drug-list-updates-effective-january-1-2026\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Prescription drug list updates effective January 1, 2026 - The Blueprint\" \/>\n<meta property=\"og:description\" content=\"The Blue Cross and Blue Shield of Kansas City (Blue KC) Medical and Pharmacy Management Committee has completed its quarterly review of the prescription drug lists (PDL) and other pharmacy programs for drug safety, effectiveness, clinical outcomes, and cost. 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