Health Insurance 8

Question 1

1. If you or your provider request a brand name prescription drug when there is a generic prescription drug available.e, you will be responsible for:

Answer 1

a. The COST SHARE amount that applies to the brand name prescription drug you received, and
b. the difference in cost between the generic prescription drug and the brand name prescription drug, unless the provider has indicated that the brand name drug is medically necessary.

Question 2

2. What is a participating pharmacy?

Answer 2

The specialty pharmacies designated solely by Blue Cross are the only Participating Pharmacy suppliers for specialty drugs.

Question 3

3. With BlueScript, you may choose to obtain specialty drugs from any pharmacy. However, any pharmacy not designated by th plan in the Medication Guide as a specialty pharmacy is:

Answer 3

considered a Non-Participating pharmacy for payment purposes under the BlueScript Pharmacy Program

Question 4

4. Specialty drugs, as designated int he Medication Guide, are not covered when:

Answer 4

purchase through the Mail Order pharmacy