888-765-5400Prescription Drugs
A generic drug is identical, or bioequivalent, to a brand name drug in dosage form, safety, strength, route of administration, quality, performance characteristics and intended use. Certain inactive ingredients that give the generic product its shape, color or flavor may be different than the brand product. Health professionals and consumers can be assured that FDA approved generic drugs have met the same rigid standards as the innovator drug. Although generic drugs are chemically identical to their branded counterparts, they are typically sold at substantial discounts from the branded price.
Depending upon your benefit design, you may substantially lower your out-of-pocket expense by using a generic drug instead of the branded drug. For example, if you have a $10 generic copay (tier 1) and $35 non-preferred brand copay (tier 3), you can save $25 on every prescription just by choosing generics. For drugs you take each month, that’s a savings of $300 over an entire year. If your prescription drug benefit is based on coinsurance, generic drugs will save you money because they cost less than their branded counterparts.(In some cases, employer groups carve out the prescription drug benefit and contract with a vendor separately, please refer to your Member Guide to confirm that your pharmacy benefits are offered through
How do I get prescriptions filled through a mail order pharmacy?
BCBSNC’s prescription drug mail service is provided by Medco Health Home Delivery Pharmacy Service. If you would like to receive prescription drugs through the mail, please call Customer Service at 1-877-258-3334 or Medco Health at 1-800-711-0926 and ask for a Home Delivery Pharmacy Service Order Form. You will need to obtain a new prescription from your physician to be submitted with the order form. (In some cases, employer groups carve out the prescription drug benefit and contract with a vendor separately, please refer to your Member Guide to confirm that your pharmacy benefits are offered through BCBSNC.)
If I am going to be out of town for an extended time, how do I get an extra supply of drugs to cover me through that period?
If you will be going out of town for an extended time, benefits are available for an extended supply of up to 90 days for prescription drugs. However, you cannot refill a prescription until three-fourths of your current supply has been used. If you have not used three-fourths of your current supply but do not have enough medication to last through your trip, speak with your pharmacist about an early refill for up to an additional 30-day supply. If this amount is not enough, call BCBSNC Customer Service at 1-877-258-3334 for assistance. (In some cases, employer groups carve out the prescription drug benefit and contract with a vendor separately, please refer to your Member Guide to confirm that your pharmacy benefits are offered through BCBSNC.)
What is a drug formulary (or preferred drug list) and how does that affect me?
BCBSNC’s prescription drug formulary is a list of FDA-approved prescription drugs reviewed and maintained by the BCBSNC Pharmacy and Therapeutics (P&T) Committee, comprised of independent physicians and pharmacists. BCBSNC offers an open formulary; therefore, no drugs are considered non-formulary.
If your prescription drug benefit is based on copayments, the formulary can help you determine your copayment for a specific drug. It also provides a list of possible therapeutic alternatives that may be available at a lower copayment. If your prescription drug benefit is based on coinsurance, the formulary can help you identify any available low cost generic drugs. If you would like an updated copy of the formulary, free of charge, please call BCBSNC’s Customer Service at 1-877-258-3334. You should bring your copy of the formulary with you when you visit the doctor. You may also get formulary information by using the online Prescription Drug Search. (In some cases, employer groups carve out the prescription drug benefit and contract with a vendor separately. Please refer to your Member Guide to confirm that your pharmacy benefits are offered through BCBSNC.)
The content of the post was reprinted from Blue Cross & Blue Sheild of North Carolina.
For more information on North Carolina health insurance, please visit our website at www.nchealthplans.com or call our toll free number 888-765-5400 and speak with one of our professional authorized 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 all our office for details.