This article is intended for members enrolled in an individual health insurance plan.
No one wants to experience sticker shock at the pharmacy counter when picking up a prescription. If you have prescription drug coverage through Blue Cross and Blue Shield of Montana (BCBSMT), check your drug list before filling your prescription so you know your out-of-pocket costs before you go.
What Is a Drug List?
The BCBSMT drug list is a list of covered drugs that is reviewed by a group of doctors and pharmacists.
What Are Drug Tiers?
Prescription drug lists have different levels of coverage, which are called payment tiers. Generally, if your doctor chooses a drug that is in a lower tier, your out-of-pocket costs will be less. It’s important that your doctor consult the drug list when prescribing drugs for you to make sure the drug is covered. This may help lower your out-of-pocket costs.
How Often Is the List Updated, and Where Do I Find a Copy of the Latest Version?
The drug list is updated annually. Log in to your Blue Access for MembersSM account to see the current drug lists and learn more about your prescription drug benefits.
Be sure to review your benefit materials for details. If you have any questions about your prescription drug benefits, call the customer service number on your member ID card and select the pharmacy option.
Prime Therapeutics, LLC, is a separate pharmacy benefit management company contracted by Blue Cross and Blue Shield of Montana (BCBSMT) to provide pharmacy benefit management and other related services. In addition, contracting pharmacies are contracted through Prime Therapeutics. The relationship between BCBSMT and contracting pharmacies is that of independent contractors. BCBSMT, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics. MyPrime.com is an online resource offered by Prime Therapeutics, LLC.