Basic Option members must use a Preferred retail pharmacy to obtain prescriptions. Standard Option members can use any Preferred or Non-preferred retail pharmacy.
The Specialty Pharmacy Program provides personalized pharmacy care and close monitoring to make sure specialty medications are safe and effective.
The Discount Drug Program is available to members for specific medicines that are not covered under the regular prescription medicine benefit.
The formulary list is a list of medicines that are considered the preferred treatment for a patient's condition and that can be used as a guide for a doctor when prescribing medicine.
For certain prescription medicines, the Service Benefit Plan Pharmacy Program must determine whether the medicine is related to a service or condition that is covered under the Service Benefit Plan before benefits can be approved.
The Mail Service Pharmacy Program available to Standard Option members is a convenient way to get medications you take regularly delivered to your home.
Under Standard Option, your cost share may be waived for up to four generic prescription fills if you switch to a generic drug replacement from a brand name prescription.
Patient-Centered Care is a complimentary medication-therapy management program available exclusively to Blue Cross and Blue Shield Service Benefit Plan members in which a clinical pharmacist works individually with members over the telephone.
The Blue Cross and Blue Shield Service Benefit Plan has a special program to promote patient safety and monitor healthcare quality. The Patient Safety and Quality Monitoring (PSQM) program features a set of closely aligned programs that are designed to promote the safe and appropriate use of medications.