bcbs cvs Member Guide to Pharmacy Services and Coverage

As a BCBS CVS member, you have access to a wide range of pharmacy services and coverage options. This guide will help you navigate the ins and outs of your pharmacy benefits.

You can fill prescriptions at over 68,000 CVS Pharmacy locations worldwide, making it convenient to get the medications you need.

CVS Pharmacy is part of the BCBS CVS network, which means your prescriptions will be covered at in-network rates. This can help save you money on copays and coinsurance.

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About 390,000 BCBS members will be affected by the change, which is about 13 percent of their 2.9 million members.

Individual and small business plans will be impacted, as well as anyone who enrolled through the Health Insurance Marketplace established through the Affordable Care Act.

Larger employer groups with more than 50 participants will have the option to select one of the new pharmacy networks or keep their existing pharmacy network.

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The Public Education Employees Health Insurance Plan and state employees insurance members will not be affected by the change.

BCBS has several other pharmacy networks available, including regional chains like Walgreens and Walmart, as well as local independent community pharmacies across Alabama.

There is no cost to transfer a prescription, but what members pay for a covered drug will depend on their pharmacy benefit coverage and copays.

If you'll be affected and want to find out where you can go to get your prescriptions filled using your BCBS insurance, you can go to the BCBS website to search for a pharmacy near you.

As a member of BCBS CVS, you have several options for managing your medications. You can use the CVS Caremark Mail Service Pharmacy to get prescriptions filled, which is available to Federal Employee Program members with pharmacy benefits, as well as Commercial and Medicare Advantage members.

There are over 65,000 retail pharmacies in the BCBS CVS network, so you can easily find one near you using the Pharmacy Locator tool. This means you have plenty of options for getting the medications you need.

If your medication isn't covered by your plan, the Medication Lookup Tool can help you find covered alternatives. This can be a game-changer if you're struggling to afford your medications.

Maintenance medications, which are used to treat chronic or ongoing conditions, can be ordered through the mail service pharmacy to save money. This can be a convenient and cost-effective option for members who need to take medications regularly.

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Encouraging your patients to use the mail service pharmacy can be a great option for them. Member savings can be up to 33% for 90-day supplies of most maintenance medications.

This means one less copay for them, which can add up to significant savings over time. No additional cost for standard delivery is also a big plus.

Automatic refills can help with medication adherence, making it easier for patients to stay on track with their medication regimen.

Here's a quick breakdown of the benefits:

To visit a pharmacy and get your COVID-19 tests, you can order online through cvs.com or the CVS Pharmacy mobile app for store pickup.

You can also go to any other in-network retail pharmacy and purchase the test kits at the pharmacy counter.

To find an in-network pharmacy, click here or download the fepblue app.

You can purchase up to 8 tests per family member in a 30-day period.

OTC tests purchased at retail locations cost, on average, $12 for a single test and $24 for a double test kit.

FEP will cover up to eight (8) over-the-counter COVID-19 tests per member on a contract per calendar month.

You can get reimbursed for your over-the-counter COVID-19 tests through Blue Cross Blue Shield (BCBS). To start, you'll need to purchase FDA-authorized OTC tests at a retail location.

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You'll need to submit a Health Benefits Claim Form, which you can download here or request by calling the number on the back of your member ID card. This form will need to include an itemized receipt that clearly shows your purchase was for a COVID-19 test.

If you don't have an itemized receipt, you can send the barcode (UPC code) from your test's packaging instead. It's a good idea to keep your receipts and barcodes in a safe place, just in case.

The cost of OTC tests varies, but on average, a single test costs around $12 and a double test kit costs around $24. You can purchase up to eight over-the-counter COVID-19 tests per member on a contract per calendar month.

Here's a quick summary of the reimbursement process:

Once you've submitted your claim, BCBS will review it and mail a reimbursement check to the contract holder.