Prime Therapeutics

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BlueCross BlueSheild of Alabama logo

 

Make the most of your pharmacy benefits. Keep reading to learn how. 

You may need medicine for a very short time to treat something like an infection. Or you may need medicine for a longer time to treat a condition like diabetes. Either way, we strive to make your medicines easy to get and more affordable.

Call 877.345.6171 to speak with a Blue Cross representative.

▼   About Prime Therapeutics
We are trusted by your health plan to help you get the medicine you need to feel better and live well. Our pharmacy experts are working hard to make your medicine more affordable and your experience easier.
▼   How your pharmacy benefits work, beginning January 1, 2022.

Visit AlabamaBlue.com/NetResults1DrugList6T to view the list of medicines covered under your Blue Cross and Blue Shield of Alabama pharmacy benefits (called a formulary). Doctors and pharmacists have carefully selected the generic and brand-name drugs on the list. Drugs that aren’t on this list may cost you more.

For covered medicines, the amount you pay is called your copay, or cost share. Your pharmacy benefit plan pays the rest. Your plan may also have a deductible, which is the amount you must pay before your plan begins to pay. 

You could save money 

Did you know that generic drugs can save you up to 80 percent?1 Generic drugs are lower-cost versions of a brand-name drug. They work the same as the brand-name drug in safety, strength and effectiveness. Ask your doctor or pharmacist if a generic may be right for you.

▼   Manage Your Prescriptions

Register for or log in to your myBlueCross account at AlabamaBlue.com. Located on the right-hand side of the myBlueCross home page, the Manage My Prescriptions section provides links* for you to access tools to:

Find medicines: Look up different drugs to see if your plan covers them. You can see prices and find out if there’s a generic version to help save you up to 80 percent. • If your medicine isn’t covered, talk to your doctor. You may be able to switch to a medicine that’s on the drug list.

Find in-network pharmacies: One way we help make your medicines more affordable is by working with certain pharmacies to lower prices for you. These pharmacies make up your plan’s preferred pharmacy network. Search by pharmacy name, your location and more.

View prescription history: See your prescription drug claims history, including the medicine, fill date and what you paid. You can easily print your history for your doctor to review.

* Note: Some links direct you to Prime’s website. A Third Party Website Disclaimer will appear. Click “Accept” to access the pharmacy tools noted above.

▼   Your health plan covers trips to the doctor

Prime Therapeutics (Prime) helps you get the medicines your doctor prescribes. Prime is the pharmacy benefit manager trusted by your health plan.

▼   Pharmacy Benefit: Deductible and 6-tier copay structure New!!!!

USA Choice Plan and the USA Select Plan – Pharmacy Benefit changes effective January 1, 2022

The USA Choice Plan and the USA Select Plan pharmacy annual deductible will be $100 per individual (maximum of 3 per family).

The USA Choice Plan and the USA Select Plan copay structure for pharmacy benefits will change to a 6-tier plan:
• Generic (preferred) COPAY $10
• Generic (non-preferred) COPAY $10
• Preferred Brand Name COPAY $50
• Non-Preferred Brand Name COPAY $75
• Specialty (preferred) COPAY $150
• Specialty (non-preferred) 50% COINSURANCE

▼   Save time (and possibly money) with home delivery

Order your long-term medicines from Amazon Pharmacy.

Receive up to a 90-day supply of your medicine with free standard shipping.

Learn more at AlabamaBlue.com/HomeDeliveryNetwork or call 855.793.5326.

▼   Use a retail pharmacy

Prime offers a large national network of pharmacies where you can use your pharmacy benefits. If you use a pharmacy that’s not in your network, you could pay more. 

 

Find network pharmacies at 

AlabamaBlue.com/PrimeParticipatingPharmacyLocator

▼   Trust our experienced specialty pharmacy

Accredo, an Express Scripts® pharmacy, offers a full-service specialty pharmacy and is part of your

Pharmacy Select Network.

Accredo’s experienced pharmacists and dedicated staff focus on providing education and support to members living with chronic or complex health conditions.

Call 833.599.0728 or visit www.accredo.com to learn more.

You may also obtain your oncology specialty medications through Mitchell Cancer Institute (MCI).

Contact MCI at 833.410.6337 for details.

 

1Generic drug facts (2017, October6). U.S. Food & Drug Administration Retrieved from https://www.fda.gov/drugs/resourcesforyou/consumers/buyingusingmedicinesafely/genericdrugs/ucm167991.htm.

Accredo is a specialty pharmacy that is contracted to provide services to members of Blue Cross and Blue Shield of Alabama.

Amazon Pharmacy is contracted to provide pharmacy home delivery services to Blue Cross and Blue Shield of Alabama, an independent licensee of the Blue Cross Blue Shield Association.

BLUE CROSS®, BLUE SHIELD® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent

BCBS Plans that includes Blue Cross and Blue Shield of Alabama.