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Blue MedicareRx - Blue Cross Blue Shield MA

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Plan Information With a Blue MedicareRx (PDP) prescription drug plan, members have access to over 68,000 pharmacies across the country or can choose to have their prescription filled using our mail order pharmacy. A pharmacy directory is included in the kit members receive upon enrollment. The Blue MedicareRx formulary (list of covered drugs) is selected by Blue MedicareRx in consultation with a team of health care providers. Plan options include: Part D Plans Summary of Benefits Blue MedicareRx $5/$10/$25 Blue MedicareRx $10/$20/$35 Blue MedicareRx $5-$15-$30 Blue MedicareRx $10-$25-$45 Blue MedicareRx $10-$30-$65 Blue MedicareRxSM $15-$30-$50 Coverage Determination Form Blue MedicareRx Network Chain Pharmacy List Blue MedicareRx Top 100 Drug List Privacy Notice

Process for Transitioning Prescriptions A transition plan allows members to obtain a transition fill of non-formulary Medicare Part D medications as well as any formulary medication with a clinical prior authorization or therapy protocol requirement during their transition period. Initial Eligibility Period: New members are eligible for a transition fill during the first 90 days of membership in Blue MedicareRx. Members may obtain up to a one time fill for up to a 30-day supply of each medication during their initial eligibility period from retail, mail order pharmacies and home infusion pharmacies. Transition fills for non-formulary drugs are subject to a tier 3 co-pay. A formulary product will take the appropriate tier co-pay. Members residing in a long term care facility may obtain up to a 31-day supply as a transition fill of each medication during the first 90 days in the plan. Multiple fills of non-formulary Part D drugs are allowed (including Part D drugs on plans formulary but require clinical prior authorization or therapy protocol) during the entire length of the transition period. 2018 Sample Formulary

Specialty Medications Specialty pharmacies are used to dispense specialty medications, including biopharmaceuticals (bioengineered proteins), blood-derived products, and complex molecules used in the management of specific chronic or genetic conditions. Specialty pharmaceuticals, which are often injectable or infused medications, generally require additional education of the member, and close monitoring of the member's clinical response in collaboration with his or her physician. These may also require memberspecific dosing, medical devices to administer the medication, and/or special handling and delivery. Overall, these medications require extensive member education for safe and cost-effective use. CVS Specialty Pharmacy Brochure Specialty Drug List

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Blue MedicareRx - Blue Cross Blue Shield MA

HOME NEW ACCOUNTS ACTIVITIES AT RENEWAL RESOURCES Plan Information LEP Information Low-Income Subsidies Communications Mandatory 21-day Notice Pl...

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