Pharmacy
Your prescription benefits cover prescription drugs, self administered injectable medications and insulin. For members who enrolled in one of the Blue OptionsSM PPO Plans, diabetic test supplies are also available through your pharmacy benefit. When visiting a participating pharmacy, be sure to present your ID card to the pharmacist. You will only be required to pay the appropriate copay for each 34-day supply.
Some drugs may require prior authorization or be subject to quantity limits (see Prior Authorization Page). It is very important to make sure that prior approval is received before going to the Pharmacy.
Prescription drug copayments are limited to $2,500 per person per benefit period. After the $2,500 maximum is reached, the health benefit plan pays 100 percent of allowed prescription drug charges per benefit period.
Certain self-administered medications are excluded from the Blue OptionsSM PPO Plan medical benefit, but are covered under the prescription drug benefit. To determine whether an injectable drug is covered as a prescription drug benefit, please review this list.
This list is subject to change. As new self-administered medications become available, they will be added to this list as quickly as possible and excluded from the medical benefit.
For questions regarding your prescription benefit, please call Medco Customer Service at 1-800-336-5933, or visit Medco's Web site.
For more information on your prescription drug benefits, please visit the following links:
- $10 Generic
- $30 Preferred Brand where no generic is available
- $40 Preferred brand where a generic is available
- $50 Non-Preferred Brand
Some drugs may require prior authorization or be subject to quantity limits (see Prior Authorization Page). It is very important to make sure that prior approval is received before going to the Pharmacy.
Prescription drug copayments are limited to $2,500 per person per benefit period. After the $2,500 maximum is reached, the health benefit plan pays 100 percent of allowed prescription drug charges per benefit period.
Certain self-administered medications are excluded from the Blue OptionsSM PPO Plan medical benefit, but are covered under the prescription drug benefit. To determine whether an injectable drug is covered as a prescription drug benefit, please review this list.
This list is subject to change. As new self-administered medications become available, they will be added to this list as quickly as possible and excluded from the medical benefit.
For questions regarding your prescription benefit, please call Medco Customer Service at 1-800-336-5933, or visit Medco's Web site.
For more information on your prescription drug benefits, please visit the following links:
