888-765-5400Prescription Drug Coverage
Blue Cross Blue Shield of NC (BCBSNC) offers prescription drug coverage through our Blue Advantage products.
Getting prescription medications is simple. The following is a brief overview of a standard pharmacy benefits plan.
- Visit a participating pharmacy with your prescription and your BCBSNC ID card.
- A copayment or coinsurance amount is required for a prescription, unless the copayment or coinsurance is waived. Copayments are the amounts paid for each prescription. Copayments or coinsurance are determined by the tier classification for a medication.
- Claims are filed electronically. No paperwork is required.
Some medications require prior approval from BCBSNC before the prescription can be accepted for payment.
BCBSNC provides coverage under its prescription drug benefit for self-administered injectable medications.
Specialty medications covered under the pharmacy benefit must be filled by a retail or mail order pharmacy participating in the Retail specialty drug network. These medications are marked with an asterisk (*).
Medical supervision and/or instruction may be required for certain injectable products. Some self-administered medications may be covered either by pharmacy or medical benefits. Review our medical policy updates page for more information, or call Customer Service at the number on your BCBSNC ID card.
Do you suffer from common ailments such as allergies, headache or heartburn?
An OTC medication may help. OTC medications can be purchased without a prescription and can effectively treat many common health conditions.
Why choose OTC medications?
OTC medications are typically used for symptomatic relief of minor health conditions, including headaches, colds and fever. OTC medications usually cost much less than prescription medications.
Chances are your Blue Cross and Blue Shield of North Carolina prescription drug benefit is provided through Medco Health, Inc. If so, you may want to take advantage of the services offered by Medco Health’s mail order pharmacy (Home Delivery Service). Note: not all members have access to Medco Health’s Home Delivery Service. One way to check is to look for “Paid BNCDRUG” listed on your ID card next to “Rx Service:”.
You can use Medco Health’s Home Delivery Service two ways:
- Call at 1-800-711-0926
- Visit the Web site: www.medcohealth.com
For more information on health insurance coverage in North Carolina, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our qualified agents. Our agency provides coverage for health insurance in North Carolina through Blue Cross Blue Shield of North Carolina (BCBSNC). You may qualify for a 15% healthy lifestyle discount if you are in excellent health. Call us for details.