bcbs Caremark Pharmacy Options and Benefits

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As a member of BCBS Caremark, you have access to a wide range of pharmacy options and benefits. BCBS Caremark has a large network of over 68,000 pharmacies nationwide, including major chains like CVS, Walgreens, and Rite Aid.

You can fill prescriptions at any of these pharmacies, and many of them offer convenient services like online ordering and same-day pickup. BCBS Caremark also offers a 90-day mail-order option for maintenance medications, which can help you save time and money.

BCBS Caremark has a tiered copayment system, which means that you'll pay a different copayment amount depending on the type of medication you're taking. For example, you may pay a lower copayment for a generic medication compared to a brand-name medication.

By taking advantage of BCBS Caremark's pharmacy options and benefits, you can save money, streamline your prescription process, and focus on your health and well-being.

For more insights, see: Bcbs Pharmacy

Mail Service Pharmacy Options

You can save up to 33% on your 90-day medication supplies by using the mail service pharmacy, with no additional cost for standard delivery.

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The mail service pharmacy can help with medication adherence through automatic refills.

If your prescriber e-prescribes, they should send the prescription to CVS Caremark Mail Service Pharmacy at One Great Valley Blvd., Wilkes Barre, PA 18706.

You can also fill your mail service pharmacy prescriptions through various options, including the web, phone, or mail.

To request a prescription through the web, sign into your Blue Cross account at bluecrossma.org.

A representative will assist you by phone to get started, including coordinating the prescription request with your prescriber as needed.

To request a prescription through mail, complete a CVS Caremark Mail Service Order Form, which can be obtained by calling CVS Customer Care.

Allow five days for delivery from the date the order was sent.

Certain controlled substances and opioid prescriptions cannot be filled through the CVS Caremark Mail Service Pharmacy.

Member Options for Pharmacy Prescriptions

If you need to fill your prescription through the CVS Caremark Mail Service Pharmacy, there are several options available to you. You can request a new prescription with the mail service pharmacy by signing into your Blue Cross account at bluecrossma.org.

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You can also get assistance over the phone, where a representative will help you get started, including coordinating the prescription request with your prescriber if needed.

If you prefer to fill out a form, you can complete a CVS Caremark Mail Service Order Form, which can be requested by calling CVS Customer Care. Once complete, mail the form to the address listed on the form and include your paper prescription.

Please allow five days for delivery from the date the order was sent.

Here are the options summarized:

  • Web: Sign into your Blue Cross account at bluecrossma.org to request a new prescription with the mail service pharmacy.
  • Phone: Call for assistance and coordination with your prescriber.
  • Mail: Complete a CVS Caremark Mail Service Order Form and mail it to the address listed.

Note that certain controlled substances and opioid prescriptions cannot be filled through the CVS Caremark Mail Service Pharmacy.

Pharmacy Formulary and Policy

Blue Cross members have several options for filling mail service pharmacy prescriptions. The member can sign into their Blue Cross account online to request a new prescription with the mail service pharmacy.

If the prescriber doesn't send the prescription electronically or by fax, the member can call a representative to assist with getting started, including coordinating the prescription request with the prescriber. Certain controlled substances and opioid prescriptions cannot be filled through the CVS Caremark Mail Service Pharmacy.

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To access the online drug formulary, members can download printable versions from the Blue Shield website. This will help them understand which drugs are covered under their plan.

Here are some ways to access pharmacy benefits and formularies:

  • Blue Shield IFP, Small Group, Large Group, and Medicare formulary
  • Medicare With Medicaid (BlueCare Plus) Pharmacy

Blue Shield of California has a generic drug policy that outlines the criteria for generic drugs to be included in the formulary. Members can read about this policy on the Blue Shield website.

Outpatient Drug Formulary

You can access the online drug formularies for Blue Shield plans, including IFP, Small Group, Large Group, and Medicare.

The formularies can be downloaded and also printed out for reference.

To find the specific formulary for your plan, you can search online.

Blue Shield IFP, Small Group, Large Group, and Medicare formularies are available for download.

Additional reading: Bcbs Online Visit

Generic Drug Policy

Blue Shield of California has a policy regarding the prescription of generic drugs. They must meet specific criteria to be included in the formulary.

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Generic drugs are preferred over brand-name drugs for most conditions, but there may be exceptions. This is because generic drugs are often just as effective and safer as brand-name drugs.

The generic drug policy is in place to ensure that patients have access to cost-effective medications. By choosing generic drugs, patients can save money on their prescriptions.

In some cases, Blue Shield of California may not cover a generic drug if it's not as effective as the brand-name version. This is usually the case for medications that have a narrow therapeutic index.

Take a look at this: Bcbs Denied Claim

Pharmacy Prior Authorization

You can download and print prior authorization forms for certain prescription drugs through BCBS Caremark. These forms are available for Blue Shield IFP, Small, Large Group, and Medicare members.

Prior authorization is a process that requires a doctor's approval before a prescription is filled. This helps ensure that the medication is necessary and not excessive.

To get started, you can visit the BCBS Caremark website and search for the prior authorization forms you need. They have forms for oral, topical, and home self-administered injectable prescription drugs.

Having the necessary forms can save you time and hassle in the long run. It's also a good idea to review the forms carefully before submitting them to ensure everything is in order.

Medicare and Medicaid Pharmacy

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Medicare With Medicaid (BlueCare Plus) plans include prescription benefits as part of your Medicare coverage.

You can understand your pharmacy benefits by accessing a selection of forms that are available to you.

Medicare With Medicaid (BlueCare Plus) plans cover prescription drugs, so you can focus on your health without worrying about the costs.

These plans offer a range of benefits, including coverage for medications, to help you manage your health effectively.

You can see what drugs are covered by accessing the selection of forms that are available to you.

By having access to these forms, you can make informed decisions about your medication and your care.

If this caught your attention, see: Bcbs Medicare Dental

Frequently Asked Questions

Is CVS Caremark part of BCBS?

No, Blue Shield of California is no longer partnering with CVS Health's Caremark as its pharmacy benefit manager. Instead, it will use Amazon Pharmacy and Mark Cuban Cost Plus Drug Company, among others, for pharmacy services.

What insurance is Caremark under?

Caremark is part of the CVS Health family of companies, specifically under Aetna. See Evidence of Coverage for details on plan benefits and changes.

Abraham Lebsack

Lead Writer

Abraham Lebsack is a seasoned writer with a keen interest in finance and insurance. With a focus on educating readers, he has crafted informative articles on critical illness insurance, providing valuable insights and guidance for those navigating complex financial decisions. Abraham's expertise in the field of critical illness insurance has allowed him to develop comprehensive guides, breaking down intricate topics into accessible and actionable advice.

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