This article is intended for members enrolled in an individual health insurance plan.
Just as it matters whether your doctor and other providers are in your health plan’s network, it also matters where you fill your prescriptions.
In fact, your 2017 benefits may include a new Preferred Pharmacy Network.
If your plan has a new Preferred Pharmacy Network, there are some things you should know:
- When you fill a prescription for up to a 30-day supply of a covered prescription drug from a retail pharmacy that participates in the Preferred Pharmacy Network, you may pay the lowest copay or coinsurance amount.
- If you fill a prescription at a non-preferred, in-network pharmacy, you may pay a higher copay or coinsurance amount than you would for a preferred in-network pharmacy.
- You can also fill a prescription for up to a 90-day supply of a covered drug at a preferred pharmacy.
Pharmacies participating in the 2017 Preferred Pharmacy Network are:
- Walmart (including Sam’s Club Pharmacy)
- Albertsons (including United Supermarkets)
- AccessHealth (a group of independent pharmacies)
If you need to switch to a new pharmacy that’s in the Preferred Pharmacy Network, transferring your prescriptions is easy. Just do one of the following:
- Take your prescription bottle/bag to your new pharmacy. They can contact your current pharmacy to transfer your prescription.
- Call your new pharmacy and ask them to contact your current pharmacy for your prescription information.
- Ask your doctor to contact your new pharmacy with your prescription information.
A “preferred” or “participating” pharmacy has a contract with Blue Cross and Blue Shield of Texas (BCBSTX) or BCBSTX’s pharmacy benefit manager (Prime Therapeutics) to provide pharmacy services at a negotiated rate. The terms “preferred” and “participating” should not be construed as a recommendation, referral or any other statement as to the ability or quality of such pharmacy.