Shop Plans

Members

Type of Plans
- Medicare
- Health
- Dental
- Vision
Helpful Information
Special Groups

Employers

Get Started
Helpful Information

Agents

Get Started
Help Your Members

Español

Prescription medication Semglee is experiencing a shortage. If you are impacted, contact your provider. Learn more.

Knowledge Center

Pharmacy benefits

We're here to help you understand your drug coverage, learn about pharmacy copays, and get prior approval when needed.

How your pharmacy benefits work

Bring your Blue Cross and Blue Shield of North Carolina (Blue Cross NC) member ID card to your in-network pharmacy along with a prescription from your doctor. You can also ask your doctor to send the prescription straight to your pharmacy.

Your pharmacist will automatically send a claim to Blue Cross NC. Once the claim processes, Blue Cross NC may cover a portion of the total cost without any additional paperwork required. Depending on your coverage, you may only be responsible for paying a copay.

Find an In-Network Pharmacy

Understanding prescription drug costs

Some prescription drug plans require you to pay a reduced cost – also called a copay – when picking up medications. The rest of the cost is covered by your health insurance plan.

Drugs come in 3 forms: brand-name, generic, and specialty. Most generic drugs have a lower copay, while specialty drugs tend to have the highest copay.

Learn More About Drug Costs

Using Amazon Pharmacy

Home deliveries help Blue Cross NC members save time, save money, and stay healthy. Use Amazon Pharmacy to set up your 90-supply of medication. Getting started is easy.

The online purchase experience lets members compare prices. Whether using your co-pay, or MedsYourWay® discount card price, all eligible and covered purchases may count toward your out-of-pocket costs.
Save money by choosing a 90-day supply and generic medications.
Automated features, like shipping updates, auto-refill, and notifications make the pharmacy experience easier.
Fast, FREE delivery
24/7 pharmacist support

Get Started With Amazon Pharmacy

Search for drug coverage

Under 65 drug search

Use our drug search tool to find a list of covered drugs and medicines that may need a prior authorization. You can search for prescription drugs, such as generics, brand-names, and speciality medicines.

Search Drugs

Medicare drug search

Type the drug name and dosage into the search tool to find out if it is covered by your plan, the cost-share, and if you need prior authorization from your doctor.

Search Drugs

Non-formulary drugs

Sometimes, doctors prescribe a medication not on your plan's approved list. These are called non-formulary drugs. Doctors may prescribe non-formulary drugs when covered medications don't work for you.

Learn About Non-formulary Drugs

Additional prescription drug resources

Individual and family members (under age 65)

The Blue Cross NC mail order prescription program offers you the convenience of receiving up to a 90-day supply of medication delivered to you with free standard day shipping through Amazon Pharmacy (MedsYourWay®) and Express Scripts® Pharmacy (ESI). You can order your prescriptions online or through the mail – choose whatever works best for you.

For MedsYourWay, Amazon Prime members get free 2-day delivery; 5-day delivery without Amazon Prime. Follow the easy sign-up process at Amazon⁠ or call 855-963-4546. If you are not already an Amazon customer then you’ll need to sign up, confirm your identity and then follow the instructions.

For ESI, register online at Express Scripts⁠ or call 833-599-0450.

Medicare members (age 65+)

The Blue Cross NC mail order prescription program offers you the convenience of receiving up to a 90-day supply of medication delivered to you with free standard day shipping. Typically, you should expect to receive your prescription drugs within 5 to 14 days (using standard shipping) from the time that the mail order pharmacy receives the order.

Learn more about getting prescriptions by mail for Medicare members.

Corporate Medical Policy: Place of Service for Medical Infusions (PDF)

Frequently asked questions

Reimbursement varies per plan. Please refer to your Member Guide to find out if benefits are available for out-of-network pharmacies.

Our prescription drug mail service is provided by Prime. You can order your prescriptions online or through the mail.

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. However, depending upon your benefit design, you may substantially lower your out-of-pocket cost by using a generic drug instead of the brand name one.

Drug shortages happen when there's not enough supply of a medication to meet the current or expected demand. Shortages can occur for various reasons, including production problems, recalls, and supply chain issues.

This may lead to complications when trying to fill your prescription, but our members’ well-being is our top priority. We are committed to minimizing disruptions in member care.

Our team of licensed clinical pharmacists carefully reviews each reported drug shortage that may impact our members. Depending on the drug shortage and impact, our team considers temporary alternative options so members can continue receiving the medications they need.

When appropriate, we notify affected members and doctors to help them navigate the situation as smoothly as possible. If a medication you need is experiencing a shortage, contact your health care provider to discuss available alternatives that best meet your needs.

Check the FDA database of current drug shortages or report a drug shortage to the FDA.

See More Prescription FAQ