This article is intended for members enrolled in an individual health insurance plan.
Just as it matters whether your doctor and other providers are in your health plan’s network, it also matters where you fill your prescriptions.
In fact, your 2017 benefits may include a new Value Pharmacy Network.
If your plan has a new Value Pharmacy Network, there are some things you should know:
- When you fill a prescription for up to a 30-day supply of a covered prescription drug from a retail pharmacy that participates in the Value Pharmacy Network, you may pay the lowest copay or coinsurance amount.
- If you fill a prescription at an in-network pharmacy that is not part of the Value Pharmacy Network, you may pay a higher copay or coinsurance amount than you would for a value in-network pharmacy.
- You can also fill a prescription for up to a 90-day supply of a covered drug at a value network pharmacy.
Pharmacies participating in the 2017 Value Pharmacy Network are:
- Walmart (including Sam’s Club Pharmacy)
- Albertsons (including Osco Drug and Safeway)
- AccessHealth (a group of independent pharmacies)
- LeaderNET Pharmacies (a group of independent pharmacies)
If you need to switch to a new pharmacy that’s in the Value Pharmacy Network, transferring your prescriptions is easy. Just do one of the following:
- Take your prescription bottle/bag to your new pharmacy. They can contact your current pharmacy to transfer your prescription.
- Call your new pharmacy and ask them to contact your current pharmacy for your prescription information.
- Ask your doctor to contact your new pharmacy with your prescription information.
A “value” or “participating” pharmacy has a contract with Blue Cross and Blue Shield of Montana (BCBSMT) or BCBSMT’s pharmacy benefit manager (Prime Therapeutics) to provide pharmacy services at a negotiated rate. The terms “value” and “participating” should not be construed as a recommendation, referral or any other statement as to the ability or quality of such pharmacy.