Understanding Bcbs Preferred Pharmacy and Your Plan

Having a preferred pharmacy can save you money on your prescriptions.

BCBS has a list of pharmacies it considers preferred, and using one of these pharmacies can give you lower copays and coinsurance rates.

These pharmacies have contracted with BCBS to offer discounted rates, which are then passed on to you.

By using a preferred pharmacy, you can save up to 50% on certain medications.

Blue Shield of California offers two pharmacy network types for commercial plans: Rx Ultra and Rx Spectrum. Rx Ultra is available for Individual and Family Plans, Covered California plans, most Small Business plans, and most Large Group plans.

You can visit any participating network pharmacy with Rx Ultra, but you'll be responsible for the copay or coinsurance listed in your benefits. If your plan has a deductible, that could also impact how much you pay.

For Small Business and most Large Group plans, you can get an extended supply of maintenance medications from any participating network pharmacy.

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Rx Spectrum, on the other hand, offers cost savings when you fill a prescription at one of the preferred pharmacies: CVS, Costco, Safeway, and Vons.

You can still use non-preferred network pharmacies, but you could pay a higher cost share for your prescriptions.

Specialty pharmacies fill prescriptions used to treat certain complex or chronic conditions that usually require close monitoring and special handling.

Here are some specialty pharmacies in the Blue Shield network:

The pharmacy network may change at any time, so be sure to stay informed about any updates.

You can choose from two pharmacy network types with Blue Shield of California commercial plans: Rx Ultra and Rx Spectrum.

Rx Ultra is available for Individual and Family Plans, Covered California plans, most Small Business plans, and most Large Group plans. This network allows you to visit any participating pharmacy nationwide.

Rx Spectrum serves Small Business Trio HMO plans, Small Business Tandem PPO plans, and select Large Group plans with the Rx Spectrum rider. It offers cost savings when you fill a prescription at one of the preferred pharmacies, which include CVS, Costco, Safeway, and Vons.

If you have a Small Business or Large Group plan, you can get an extended supply of maintenance medications from any participating network pharmacy. This can help you save money on your prescriptions.

Here are some preferred pharmacies in the Rx Spectrum network:

Highmark Blue Cross Blue Shield has a preferred drug list, also called a formulary, which includes all medicines covered by Child Health Plus (CHPlus). Your doctor doesn't need to get preapproval to prescribe medicines on this list.

If your doctor wants to prescribe a drug that isn't on this list, they will need to get preapproval from Highmark Blue Cross Blue Shield before you can fill your prescription.

Generic drugs are covered when available, and they are equal to brand-name drugs and approved by the Food and Drug Administration.

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To find Highmark plan pharmacies, you can look in your new member enrollment package for a list of pharmacies in our plan.

You can also search our list of plan drugstores online.

If you need help, call Pharmacy Member Services at 1-833-232-1713 (TTY 711) 24 hours a day, seven days a week.

Your local pharmacy can also provide assistance and help you find a plan pharmacy.

You can reach Pharmacy Member Services at 1-833-232-1713 (TTY 711) 24 hours a day, seven days a week.

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Specialty Pharmacy Services are available through our network, which includes pharmacies that deliver specialty medications right to your door.

You can find specialty pharmacies like Walgreens Specialty Pharmacy and Accredo Specialty Pharmacy in our network.

The pharmacy network may change at any time, so we'll keep you informed when necessary.