To take advantage of your Rx Drug card coverage, simply show your Blue Cross and Blue Shield of Illinois ID card at the pharmacy and pay the prescription drug copayment or coinsurance. Your out-of-pocket cost is determined by your benefit plan, the drug prescribed by your doctor and whether the drug is listed on our drug formulary.
Consider Talking to Your Doctor About Generic Drugs
- If your doctor writes a prescription for a brand drug that does not have a generic equivalent, consider asking if an appropriate generic alternative is available.
- You can also let your pharmacist know that you would like a generic equivalent for a brand drug, whenever one is available. Your pharmacist can often substitute a generic equivalent for its brand counterpart without a new prescription from your doctor.
- Only your doctor can determine whether a generic alternative is right for you and must prescribe the medication.
Mandatary Mail order for Maintenance Medications - Effective January 1, 2010
Maintenance medications are those drugs you may take on a regular basis for contraception or to treat conditions such as high cholesterol, high blood pressure or diabetes. You will be able to receive coverage for the first fill plus two refills at a retail pharmacy for covered maintenance drugs. After that, to receive coverage, you will be required to obtain them through mail service from PrimeMail® Pharmacy in order to receive benefits.
Using mail service to obtain covered maintenance medications may save you time and money: Your medications will be delivered directly to you, to the address of your choice.
If you are currently taking a covered maintenance medication, to continue to receive coverage, you will need a new prescription from your doctor for up to a 90-day supply. Depending on your circumstances, your doctor may write your prescription for three refills. To begin using mail service, you can contact PrimeMail by calling the Pharmacy Program number on the back of your BCBSIL ID card. At your request, PrimeMail will contact your doctor for the new prescription. Or, you may contact your doctor to request a new mail service prescription to submit, along with your completed order form and payment, to PrimeMail. To print a form, log in to Blue Access® for Members and visit your Rx Drugs page. With either option, you can expect your new supply of medication to arrive about two weeks after submitting your completed order form, the new prescription and your payment to PrimeMail.
If you are prescribed a new covered maintenance medication, these are the steps to follow to use PrimeMail:
- Ask your doctor for two prescriptions - one for up to a 34-day supply to fill at a retail pharmacy and one for up to a 90-day supply with three refills to send to PrimeMail Pharmacy.
- Log into Blue Access® for Members to download an order form to complete and mail with your prescription to the address on the form. Or, complete the form online.
- Allow about two weeks after you send your completed order form (unless completing online), prescription and payment to receive your medication.
Mandatary Speciality Pharmacy Program - Effective January 1, 2010
Members who have a complex medical condition requiring specialty medications are required to purchase their covered medications through Triessent® specialty pharmacy order to receive benefits. No benefits are available for specialty medications purchased at any other pharmacy, including but not limited to, retail pharmacies, PrimeMail, Accredo, etc. Triessent® will dispense up to a 30-day supply of medication per prescription.
Through Triessent®, members using covered specialty medications can have their medication delivered directly to them, as well as receive coverage coordination and support. There is no additional fee for these services. When members purchase their covered specialty medications from Triessent®, they receive valuable services to help in managing their therapy, including:
- Coordination of coverage between the member, physician and BCBSIL
- Convenient delivery of medication to the member or their physician's office
- Educational materials about many conditions, provided by drug manufacturers
- Information about managing potential medication side effects
- Syringes, sharps containers and other supplies with every shipment for self-injectables
- 24/7/365 phone access to a pharmacist for medication issues.
To begin using Triessent, call (888) 216-6710, Monday through Friday between 8 a.m. and 7 p.m. Eastern time, to transfer your prescription. When you call have your BCBSIL ID card and the following information available:
- Name, address, phone number
- Current pharmacy's name and phone number
- Prescription number and name of medication
- Physician's name, phone and fax numbers
