What Is Blue Cross Patient Centered Care Prescription Consult Program
Coronavirus Update
FEP will waive early medication refill limits on 30-day prescription maintenance medications. Learn more here.
Pharmacy coverage you can count on
We want to make sure you and your family have convenient access to the prescription drugs you need. That's why we have a variety of programs that help you get your prescriptions at your local pharmacy or delivered right to your door. Watch our video to see how we help keep your out-of-pocket costs low for the medications you and your family need.
Get access to over 57,000 retail pharmacies nationwide
We have a network of over 57,000 Preferred retail pharmacies nationwide to fill your prescriptions. Use our pharmacy locator tool to find one near you.
Find a Pharmacy
Retail Pharmacy Program
All of our members can access a network of over 57,000 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.
Mail Service Pharmacy Program
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.
Specialty Pharmacy Program
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.
Patient-Centered Care (P-Care) Program
Available to Service Benefit Plan members at no cost, we offer a complimentary medication-therapy management program. You can work directly with a clinical pharmacist over the phone to get help managing medication therapy and lifestyle choices to help improve your health outcomes.
Goals of the program are to help:
- Identify and resolve medication therapy problems
- Improve outcomes of medication therapy
- Provide member education about medication therapy, including prescription, non-prescription and herbal products
- Educate members on key lab values
- Improve provider/patient dialogue
Learn more about Patient-Centered Care by accessing our resource brochures.
Standard Option Generic Incentive Program
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.
Discount Drug Program
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.
*If the cost of your prescription is less than your copay, you pay only the cost of your prescription. The Mail Service Pharmacy Program will charge you the lesser of the prescription cost or copay when you place your order.
Take a closer look at our prescription drug formularies
A formulary is a list of covered drugs. We have a unique formulary for each of our three plan options.
See Formularies
Source: https://www.fepblue.org/pharmacy
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