Retail Prescription Drug Programs
We work with Prime Therapeutics in the administration of our retail prescription drug products, to give you a variety of valuable benefits including access to nearly 50,000 network pharmacies nationwide.
When you show your identification card at a contracting network pharmacy, you will receive up to 15 percent savings on prescription drugs, based on current pricing. And, if the contracting pharmacy offers a special price on a medication that is lower than the price offered through this program, you will never pay more than the lowest price.
BlueRx Direct has a variety of deductible and coinsurance options to choose from. These amounts cannot be applied toward the health benefit deductible and coinsurance maximums.
BlueRx Card has a selection of low-cost copay options available.
BlueRx Health offers coverage for prescription drugs subject to the deductible, coinsurance or shared payment of the basic medical plan.
BlueRx Rider offers a choice of cost-saving deductible and coinsurance options. These amounts do not apply toward the health benefit out-of-pocket maximums.
Mail Service Prescription Drug Program
We work with PrimeMail™ Pharmacy in the administration of our mail order prescription drug program.
At the PrimeMail™ Pharmacy website, you can:
- Order your mail order prescriptions online.
- Check the status of a mail order prescription being filled.
- Find out how many refills remain on a mail order prescription.
- Access a variety of health related topics.
To access any of this information, just have your ID card handy so you can respond should you be asked for your identification number. You also will be asked for your ZIP code if you are checking on the status of an order or requesting a refill.
Three-tier Benefit Design
This program is a managed care prescription drug plan that provides coverage for insulin and outpatient prescription drugs approved for general use in the United States by the Federal Food and Drug Administration and requiring a written prescription order from a doctor.
Prime Therapeutics assists in the administration of this program on behalf of BCBSKS. Through Prime we are able to offer pharmacies immediate online access to member eligibility information.
Prime also offers utilization review, which alerts pharmacists to potential drug interactions between medications you may be currently taking and the new prescription medication being filled. Drug utilization review allows the pharmacist to provide you with critical information regarding your prescription medication.
Prime also provides a drug formulary, or preferred medication list to help you make wise purchasing decisions. The greatest savings can be realized by having prescription filled by a contracting network with a generic drug. A more expensive copay will be required when the prescription is filled with a brand drug and the most expensive copay will result when the prescription is filled with a brand drug not listed on the formulary.
When purchasing prescriptions, the employee must show their BCBSKS identification card and use a network pharmacy. There are nearly 50,000 contracting network pharmacies nationwide. To identify a network pharmacy, look for the BCBSKS decal, check out our online Pharmacy Finder, ask the pharmacist or call our customer service at 1-800-432-3990.
For more details about the three-tier benefit design, see a list of answers to frequently asked questions.