BlueRx and BlueRx Express plans combine the prescription drug benefit with the medical benefit. Prescription costs are subject to the same deductible and out-of-pocket maximums that apply to other medical costs. Some plans also have an additional deductible for prescription drugs. When members use a network pharmacy for their prescriptions, the pharmacist uses a computer to check benefits and determine the amount members must pay for their prescriptions. Members always pay the lower of the pharmacy’s prices or our special discounted prices for their prescriptions.
Members who have the BlueRx plan must complete a prescription drug claim form and attach their prescription receipt(s) in order to receive reimbursement. Members should mail the completed and signed form and receipt(s) to the address on the form. We automatically file claims for members who have the BlueRx Express plan. Depending on their benefit, they should receive reimbursement within two to four weeks after they receive their prescription(s).
No matter which plan a member has, the benefit contract determines the amount we reimburse for prescriptions. We may also reimburse members who don't use a network pharmacy for their prescriptions or who don't show their ID cards the amount we would have paid at a network pharmacy, even if they paid more than the network pharmacy price.