Pharmacy

Service Benefit Plan members can access a network of over 60,000 Preferred pharmacies nationwide.

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CORONAVIRUS UPDATE: FEP will waive early medication refill limits on 30-day prescription maintenance medications. Learn more here.

As a Blue Cross and Blue Shield Service Benefit Plan member, you have several options to obtain the prescription drugs you need. Contact us with questions, or review our list of FAQs.

Retail Pharmacy Program

Basic Option members (without Medicare Part B primary coverage) and FEP Blue Focus members must use a Preferred retail pharmacy to obtain prescriptions. Standard Option members can use any Preferred or Non-preferred retail pharmacy.

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Specialty Drug Pharmacy Program

The Specialty Drug Pharmacy Program provides personalized pharmacy care and close monitoring of your specialty drugs to ensure you receive the support you need.

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Discount Drug Program

The Discount Drug Program is available to members for specific drugs that are not covered under the regular prescription drug benefit.

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Formulary

The formulary list is a list of drugs that are considered the preferred treatment for a patient's condition and that can be used as a guide for a doctor when prescribing drugs.

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Prior Approval

For certain prescription drugs, the Service Benefit Plan Pharmacy Program must determine whether the drug is related to a service or condition that is covered under the Service Benefit Plan before benefits can be approved.

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Mail Service Pharmacy Program

The Mail Service Pharmacy Program (available to Basic Option members with Medicare Part B primary coverage and all Standard Option members) is a convenient way to get drugs you take regularly delivered to your home.

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Standard Option Generic Incentive Program

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.

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Patient-Centered Care (P-Care)

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.

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Patient Safety

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 drugs.