Pharmacy

All of our members can access a network of over 55,000 Preferred pharmacies across the U.S. Simply show your member ID card at the pharmacy. There is no deductible—you only pay your applicable cost share amounts based on the drug tier and your coverage type.

If you have Standard Option, you may still purchase your prescription drugs and supplies from Non-preferred retail pharmacies. The pharmacy will ask you to pay the full amount for these items and then you will need to file a claim with us for reimbursement.

All Standard Option members, as well as Basic Option members with Medicare Part B primary, can get prescription drugs they regularly take conveniently delivered to their home. This includes maintenance or long-term drugs, such as those for high blood pressure, arthritis or other chronic conditions. You can get up to a 90-day supply for one copay.* You also have access to a registered pharmacist 24/7.

To participate in the Mail Service Pharmacy Program, complete the Mail Service Drug Prescription Form, call CVS Caremark at 1-800-262-7890 or place an order through your MyBlue member account.

For members with complex health conditions who need specialty drugs, you can get access to our Specialty Drug Program. Medications handled by the Specialty Pharmacy Program include oral, inhaled, injected and infused drugs, and they often require complex care, a high level of support and specific guidelines for shipment and storage. See if your medication is on our Specialty Drug List.

The Specialty Pharmacy Program offers more than just medication. You get personalized support whenever you need it, including:

• Convenient delivery directly to your home or doctor's office.
• 24/7 access to pharmacists and nurses specifically trained in conditions like yours.
• Digital tools available here to refill prescriptions and monitor order status.

If your doctor prescribes you a specialty drug, call the Specialty Pharmacy Program at 1-888-346-3731.The Specialty Pharmacy Program team will assist you with any questions or concerns about your specialty drug benefits.

Available to Service Benefit Plan members at no cost, we offer a comprehensive medication-therapy management program. You can speak directly with a clinical pharmacist over the phone or via video chat to get help managing your medication therapy and lifestyle choices so you can reach your health goals. 

Our care team helps you:

• Understand your medications and possible side effects
• Review your lab results to make sure your medications are safe and working for you
• Work directly with your health care provider(s) if there are any medication-related concerns
• Find ways to save money on your medications
• Learn more about your health care benefits and resources
• Evaluate your use of herbal products, supplements and over-the-counter treatments for safety and appropriateness

Learn more about Patient-Centered Care or call 1-866-465-2505 to enroll today. 

For Standard Option members who switch to a generic medication, we’ll waive your cost share for your first four prescription fills or refills.

View and download the Generic Incentive Program Drug List to see if there’s an alternative generic drug that can appropriately treat your condition. If your healthcare provider agrees, then simply request a new prescription for up to a 90-day supply of the generic drug alternative. Fill your prescription as you normally would by using the Retail or Mail Order Pharmacy Programs for non-specialty drugs or the Specialty Pharmacy Program for specialty drugs.

Members can get lower prices on prescription drugs not covered by our pharmacy benefits. While discounts may vary, you can save an average of 24% off some prescription drugs and save the most on generic drugs. Discounted prices are only available at participating retail pharmacies.

To learn more on how to fill your prescriptions using this program, view and download our Discount Drug Program Quick Reference Guide.