2023-2024 Benefits Guide
MEDICAL PLAN FEATURES Preferred Pharmacy Network
A Preferred Pharmacy Network is included in your prescription drug benefit plan. When you fill a prescription for up to a 30-day supply of a covered prescription drug from a retail pharmacy that contracts to participate in the Preferred Pharmacy Network, you may pay the lowest copay/coinsurance amount. If you fill a prescription at a non- preferred, in-network pharmacy, you may pay a higher copay or coinsurance. You can also fill a prescription for up to a 90-day supply of a covered prescription drug at a retail pharmacy that participates in the Preferred Pharmacy Network. To find a preferred pharmacy, sign in to myprime.com. Please note that changes may be made to the participating pharmacies in the future BCBS Top Preferred Pharmacies are: HEB, Walmart, Walgreens and Sam’s Club. IMPORTANT: CVS is out of the BCBS network . If you currently fill your prescriptions at CVS, you’ll still have access to more than 55,000 in-network pharmacies nationwide (without CVS). To find a new in-network pharmacy visit myprime.com and select “Find a Pharmacy” or call the Pharmacy Program number on the back of your member ID card. Once you find a new in-network pharmacy, you can easily transfer your prescriptions by doing one of the following: 1. Take your prescription bottle/bag to your new pharmacy. They can contact your current pharmacy to transfer your prescription. 2. Call your new pharmacy and ask them to contact your current pharmacy for your prescription information. 3. Ask your doctor to contact your new pharmacy with your prescription information. Moving to Home Delivery If you take any long-term medicine(s), consider using the PrimeMail home delivery service to help you save time and money. Up to a 90-day supply of your covered prescriptions can be shipped to you anywhere in the U.S., with free standard shipping. To choose home delivery:
1. Register and/or sign in to myprime.com. Click on “Fill with PrimeMail”. 2. Go to “Transfer to PrimeMail” and click on “Fill with PrimeMail”. You can also call PrimeMail at 800-423-1973 to transfer your prescription. Provider Finder Provider Finder from Blue Cross and Blue Shield of Texas (BCBSTX) is an innovative tool for helping you choose a provider, plus estimate, and manage health care costs. By logging in to Blue Access for MembersSM (BAM) you can use Provider Finder to: • Find a network primary care physician, specialist or hospital. • Filter search results by doctor, specialty, ZIP code, language and gender – even get directions.
• Estimate the cost of hundreds of procedures, treatments and tests and your out-of-pocket expenses. • Determine if Blue Distinction Center® (BDC), BDC+ or Blue Distinction Total Care is an option for treatment.
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