Q: How do I get prescriptions
filled through a mail order pharmacy?
A: BCBSNC's prescription drug mail service is provided by
Medco Health Home Delivery Pharmacy Service. If you would
like to receive prescription drugs through the mail, please
call Customer Service at 1-800-914-4220 and ask for a Home
Delivery Pharmacy Service Order Form. You will need to obtain
a new prescription from your physician to be submitted with
the order form. (In some cases, employer groups carve out
the prescription drug benefit and contract with a vendor
separately, please refer to your Member Guide to confirm
that your pharmacy benefits are offered through BCBSNC.)
Q: What is the difference
between generic and brand-name drugs and how does that difference
affect my benefits?
A: A generic drug is identical, or bioequivalent,
to a brand name drug in dosage form, safety, strength, route
of administration, quality, performance characteristics
and intended use. Certain inactive ingredients that give
the generic product its shape, color or flavor may be different
than the brand product. Health professionals and consumers
can be assured that FDA approved generic drugs have met
the same rigid standards as the innovator drug. Although
generic drugs are chemically identical to their branded
counterparts, they are typically sold at substantial discounts
from the branded price.
Depending upon your benefit design, you may substantially
lower your out-of-pocket expense by using a generic drug
instead of the branded drug. For example, if you have a
$10 generic copay (tier 1) and $35 non-preferred brand copay
(tier 3), you can save $25 on every prescription just by
choosing generics. For drugs you take each month, that's
a savings of $300 over an entire year. If your prescription
drug benefit is based on coinsurance, generic drugs will
save you money because they cost less than their branded
counterparts.(In some cases, employer groups carve out the
prescription drug benefit and contract with a vendor separately,
please refer to your Member Guide to confirm that your pharmacy
benefits are offered through BCBSNC.)
Q: Can I get reimbursed
for drugs I got from a pharmacy outside of the network?
A: Answers vary according to plan. For
more information, please visit the FAQs on your plan's Member
page.
Q: If I am going to
be out of town for an extended time, how do I get an extra
supply of drugs to cover me through that period?
A: If you will be going out of town for
an extended time, benefits are available for an extended
supply of up to 90 days for prescription drugs. However,
you cannot refill a prescription until three-fourths of
your current supply has been used. If you have not used
three-fourths of your current supply but do not have enough
medication to last through your trip, speak with your pharmacist
about an early refill for up to an additional 30-day supply.
If this amount is not enough, call BCBSNC Customer Service
at 1-800-914-4220 for assistance. (In some cases, employer
groups carve out the prescription drug benefit and contract
with a vendor separately, please refer to your Member Guide
to confirm that your pharmacy benefits are offered through
BCBSNC.)
Q: What is a drug
formulary (or preferred drug list) and how does that affect
me?
A: BCBSNC's prescription drug formulary
is a list of FDA-approved prescription drugs reviewed and
maintained by the BCBSNC Pharmacy and Therapeutics (P&T)
Committee, comprised of independent physicians and pharmacists.
BCBSNC offers an open formulary; therefore, no drugs are
considered non-formulary.
If your prescription drug benefit is based on copayments,
the formulary can help you determine your copayment for
a specific drug. It also provides a list of possible therapeutic
alternatives that may be available at a lower copayment.
If your prescription drug benefit is based on coinsurance,
the formulary can help you identify any available low cost
generic drugs. If you would like an updated copy of the
formulary, free of charge, please call BCBSNC's Customer
Service at 1-800-914-4220. You should bring your copy of
the formulary with you when you visit the doctor. You may
also get formulary information by using the online Prescription
Drug Search. (In some cases, employer groups carve out the
prescription drug benefit and contract with a vendor separately.
Please refer to your Member Guide to confirm that your pharmacy
benefits are offered through BCBSNC.)
