Prescription Drug Coverage

As a Blue Cross Community Health Plans℠ (BCCHP) plan member, you have Rx benefits. This means select generic and brand-name prescription drugs, medical supplies and over-the-counter (OTC) drugs are covered. 

• Your plan uses a Preferred Drug List (PDL) .
• The PDL is a list showing the drugs that can be covered by the plan.
• The PDL is provided by the Illinois Department of Healthcare and Family Services (HFS).
• BCCHP must follow the HFS provided PDL. This is to help your doctor choose which drugs to give you.

BCCHP members pay nothing ($0) for the items on the PDL. Those items will be covered as long as you:

• have a medical need for them
• have a prescription from your doctor for them
• fill the prescription at a network pharmacy
• follow the plan rules

Certain drugs on the list need prior authorization. Your doctor will need to request approval before these drugs can be prescribed. Without approval, the drugs are not covered. You can find out if your drug has any conditions or limits by checking the PDL.

Note: Blue Cross and Blue Shield of Illinois does not cover cannabis. Cannabis comes from the cannabis plant. It has delta-9-tetrahydrocannabinol (THC) as an active ingredient. Cannabis may be called marijuana. BCBSIL does not cover cannabis in any form. This includes:

• Plant seeds
• Extracted resin
• Salt or other derivative
• Any mixture or preparation of cannabis-derived compounds

Pharmacies

As a member, you have access to a wide network of pharmacies in Illinois. You must get your medicines at a network pharmacy, and you will receive up to a 30-day supply.

Delivery and Pick-Up Options

As a member, you have access to a wide network of pharmacies in Illinois. You must get your medicines at a network pharmacy, and you will receive up to a 30-day supply.

Over-the-Counter (OTC)

BCCHP members also get pre-approved OTC products one time every quarter. You can get OTC items like pain relievers and allergy medicine. These are at no cost to you. Your plan will pay up to a $25 per quarter. Only one order can be placed each quarter. The benefit amount will not roll over to the next quarter. If you do not use the full dollar amount, you will lose the remaining balance. 

To place an order, you can:

• Check the OTC Benefits Catalog  for approved items.
• Order online at https://mpaotc.com . 
• Call Member Services to order at 1-877-860-2837 (TTY: 711). 

Your order will be shipped to your address within 7 to 10 days.

Mail-Order Service

If you take certain prescription drugs on a regular basis, you can have them delivered to your home. The mail service pharmacy program provides up to a 90-day supply at one time.

Use the Mail Service Registration and Prescription Order Form  to submit your order. 

Affinity Medication Delivery Program

Do you take 8 or more maintenance medications a day? 

If so, you may be eligible for a free medication delivery program. Affinity Patient Coordination is an in-network pharmacy provider that offers dose packaging services for BCCHP members. Affinity can deliver meds directly to your home. The drugs are in convenient prepackages. This program offers a safe and easy way to manage your medicines. 

Call Affinity at 1-800-280-5645 for more information.

Please Note: Prescription drug benefits are not covered for Managed Long Term Services and Supports (MLTSS) plan members. MLTSS members should contact their Medicare Part-D plan for prescription coverage.