Some benefit plans use the Try Generics Drug List. To treat 12 common health conditions, members must try generic drugs before their plans will cover brand-name drugs. For some conditions, they can also try alternative brand-name drugs first. Members who are not sure if this drug list applies to their benefit plans can log into My Health Toolkit® for personal information about their prescription drug coverage.
If the generic and brand-name drugs aren't right for your patients, you can request an exception. If we approve your exception request, your patients will pay the highest copayment under their plans for their brand-name drugs. To request an exception, call the Caremark Prior Authorization department at 877-203-0003. Caremark is an independent company that assists in the administration of the prescription drug program on behalf of BlueCross. You can also fax requests to Caremark at 888-836-0730.
The Try Generics Drug List is subject to change at any time, but we generally make updates on a quarterly basis. Members can continue to use brand-name drugs on the list, but they will pay 100 percent of our special discounted rates or the pharmacy's charge, whichever is less.
Keeping up with drug lists for all your patients can be challenging. With electronic prescribing, it’s easier than ever to access patient eligibility, complete medication histories and drug list information for all your patients at the point of care. The Medicare Improvement for Patients and Providers Act requires ePrescriptions for Medicare patients beginning in 2012. And bonus incentives from Medicare began in 2009, so now is a great time to start!