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If this is your first time having a Medicare Advantage plan, let us help you get the most from your pharmacy benefits.
Prescription drug plans cover only those drugs eligible for coverage under Medicare Part D.
These plans come with a formulary, or a list of covered prescription drugs, which are grouped into tiers. Some drugs may be listed in more than one tier if they are available as both generic and brand-name or if there are multiple strengths for the drug.
Medicare Part D plans do not cover certain drugs that are excluded by law, such as over-the-counter medications and prescription vitamins.
Some members may qualify for the Part D Extra Help Program and Low-Income Subsidy. If you get Extra Help from Medicare to help pay for your Medicare prescription drug plan costs, your monthly plan premium will be lower than what it would be if you did not get Extra Help from Medicare. The amount of Extra Help you get will determine your total monthly plan premium as a member of our plan.
The Medicare Prescription Payment Plan is a payment option that works with your current drug coverage to help you manage your out-of-pocket drug costs by spreading your payments across the calendar year. Learn more about the Medicare Prescription Payment Plan.
Blue Medicare Advantage℠ and Blue Medicare Rx℠ members can go to any pharmacy in our network to pick up a prescription drug. Our network includes retail, long-term care, home infusion, Indian Health Service / Tribal / Urban Indian Health Program (I / T / U), specialty, and mail-order pharmacies.
Your costs for some drugs may be less at pharmacies that offer preferred cost-sharing. This is known as our Preferred Pharmacy network.
Blue Cross NC's preferred retail pharmacies include:
Experience Health Medicare Advantage℠ (HMO) and Healthy Blue + Medicare℠ (HMO-POS D-SNP) members do not have a Preferred Retail Pharmacy network. Members of these plans may go to any retail pharmacy in their network.
Amazon Pharmacy is a Blue Cross NC preferred mail order pharmacy.
Through this program, you get the convenience of having up to a 90-day supply of your medications delivered right to your home.
Healthy Blue + Medicare℠ (HMO-POS D-SNP) members do not have a Preferred Mail Order Pharmacy network. Members of this plan may use any mail order pharmacy in their network.
Find out more about prescription drug coverage, including information on benefits, how to read your Part D Explanation of Benefits (EOB), drug category tiers, and other important details.
Blue Cross and Blue Shield of North Carolina does not discriminate on the basis of race, color, national origin, sex, age or disability in its health programs and activities. Learn more about our non-discrimination policy and no-cost services available to you.
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