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Pharmacy Programs

If you're a Blue Cross and Blue Shield of IllinoisSM member with pharmacy benefits through us, you may have access to certain pharmacy programs. They focus on making specialty prescriptions easily available. They help deliver medications to your home or doctor. And they give you access to vaccines at pharmacies near you.

Home delivery pharmacy shipement.

Specialty Pharmacies

Specialty prescription drugs are used to treat conditions that are any of the following:

  • Rare or less common conditions like multiple sclerosis
  • Serious conditions like cancer or hemophilia
  • Long term conditions like rheumatoid arthritis

Drugs that treat these conditions often have special handling or storage needs. Retail pharmacies may not be able to stock these types of drugs. That’s why members may need to use a specialty pharmacy to get these medications.

Home Delivery / Mail Order Pharmacies

Why You Should Use Mail Order Pharmacies

  • Using mail order services to fill your maintenance or long-term prescriptions may reduce out-of-pocket costs.
  • Using this service is a convenient way to get medications you may take long-term such as drugs that treat high cholesterol, high blood pressure or diabetes. 
  • You may be able to order a 90-day supply. Get the Maintenance drug list  to check if your medication is included. 
  • Short-term prescriptions, such as a 10-day prescription for antibiotics or acute pain medications, should be filled at your local pharmacy.

Depending on your plan, your options may vary.

Members with HMO2 Plans

Looking for a pharmacy? If you have a BCBSIL health plan with Prime as your pharmacy benefit manager, log in to your member account to find in-network pharmacies.

The 90-day supply benefit program can save you both time and money. With this program, you have the option of getting up to a 90-day supply of long-term (or maintenance) medications through a network of contracting extended supply retail and mail service pharmacies. Maintenance medications are those drugs you may take on an ongoing basis to treat conditions such as high cholesterol, high blood pressure or diabetes.

For more information, get the 90-Day Supply Program Member Flier .

Mail Order Tips:

  • If you need to start your prescription right away, ask your doctor for a one-month supply you can fill at a retail pharmacy. 
  • You can order online, through a mobile device or over the phone. Some pharmacies offer a form you can send through the mail. Find more information when you log in to your member account  and click on the Pharmacy tab.
  • Keep in mind that medicines can take up to 5 business days to deliver after the pharmacy receives and verifies your order.

Members with non-HMO Plans

Express Scripts® Pharmacy3
Express Scripts® Pharmacy is a mail order pharmacy for members with our prescription drug coverage. It provides mail order services that can save you time and money.

Getting Started Online
You have more than one option to fill or refill a prescription online or from a mobile device:

  • Visit express-scripts.com/rx and follow the instructions to register and create a profile.
  • Log in to MyPrime.com  and follow the links to Express Scripts® Pharmacy.

Order Over the Phone
Call 1-833-715-0942, 24/7, to refill, transfer a current prescription or get started with home delivery. Please have your member ID card, prescription information and your doctor’s contact information available.

Through the Mail
To send a prescription order through the mail, log in to your account and click the Pharmacy tab. Complete the mail order form. Mail your prescription, completed order form and payment to Express Scripts® Pharmacy. For more information, download the Express Scripts® Pharmacy flier .

Vaccine Program

young woman getting a vaccine at an in-network pharmacy

Vaccines can help protect you from illnesses such as the flu, pneumonia, shingles, tetanus, and more. Vaccinations may be covered under your BCBSIL medical benefits or prescription drug benefits, based on your plan. 

Using the Vaccine Program4

You may get select vaccines at a pharmacy near you. More information is available in the member flier for the pharmacy vaccine program.

Available Vaccines

To learn more about which vaccines are available under your plan, log in to your member account. Select the Benefits tab to review your benefits and coverage.

Participating Pharmacies

If your plan covers vaccines through your prescription benefits, log in to your account and search for pharmacies. You can filter for pharmacies that offer vaccines. Before you go, know the location and hours. Check vaccine availability. Ask about limits, like age, and other requirements.

 

A pharmacy bottle with pill spilling onto surface.

Over-the-Counter Equivalent Exclusion Program

Brand and generic medications that have OTC versions available at the same strength may not be covered. Note:

  • If you decide to buy the medication – either by prescription or OTC – you may pay for its full cost.
  • Buying the OTC version may save you money.
  • To see if a specific drug is part of the program, view the OTC equivalent exclusion program drug list.
  • Talk with your doctor before changing your medications. Treatment decisions are between you and your doctor.

 

1 Accredo is a specialty pharmacy that is contracted to provide services to members of Blue Cross and Blue Shield of Illinois. The relationship between Accredo and BCBSIL is that of independent contractors. Accredo is a trademark of Express Scripts Strategic Development, Inc.

2 For members with Metallic individual and family plans (also called ACA, Marketplace or Obamacare plans) this information is for those with either HMO or POS Plans

3 Express Scripts® Pharmacy is a pharmacy that is contracted to provide mail pharmacy services to members of BCBSIL. The relationship between Express Scripts® Pharmacy and BCBSIL is that of independent contractors. Express Scripts® Pharmacy is a trademark of Express Scripts Strategic Development, Inc.

4 This applies to BCBSIL members with prescription drug benefits that include coverage for these vaccinations. Coverage for these vaccines can vary according to the type of plan you are enrolled in. If you are a member whose prescription drug plan is not administered through BCBSIL, or coverage for these vaccinations are not included in your particular plan, please contact your employer group benefits administrator for information about the availability and coverage of vaccinations under your plan.

Prime Therapeutics LLC is a separate company contracted by BCBSIL to provide pharmacy solutions. BCBSIL, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics. MyPrime.com is a pharmacy benefit website offered by Prime Therapeutics LLC.