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Prescription Drug & Pharmacy

Prescription Drug Information

Your employees' health and pharmacy benefits recently renewed with BlueChoice HealthPlan. Their benefit plan now includes a different prescription drug list (PDL) called the Tiered PDL. There is no change in the drugs the plan covers, but some of the drugs are now on a different tier. Each tier refers to a specific copayment or coinsurance level. Please see your plan documents to find out what employees will pay for each tier.

The six-tier pharmacy copay benefit is in place to better allow management of the always changing prices of drugs in the marketplace. As drug prices change and new generic medicines come into the market, you may see a change in the copay for the brand drugs that now have a generic. As the new generics become more available in the market, you may also see the copay for the generic drug increase or decrease to align with the changing cost of the drug. These changing copays are in place to better manage the pharmacy benefit and make the overall cost of health insurance more affordable.

View the 2019 Tiered Prescription Drug List

Save Money and Time

Generic drugs are medications that contain the same active ingredients as the corresponding brand-name drugs, but generally cost less. The U.S. Food and Drug Administration (FDA) requires testing of generic drugs before they are sold to make sure they are of the same quality and effectiveness as their brand-name counterparts. 

To take advantage of the savings generic drugs can provide, your employees just need to get a prescription from their doctor and take it to a network pharmacy. If the prescription is filled with a generic drug, your employees will likely pay a lower copayment. If the prescription is filled with a brand-name drug that has a generic option, your employees will pay a higher copayment or coinsurance based on their benefit plan, plus the price difference between the generic and the brand-name drug. At no time will your employees pay more than the retail price.

Drug Look Up Tool

Your employees can use the drug lookup tool to search for information on a specific drug. This link leads to a third party website. That party is solely responsible for the content and privacy policies on its site. Caremark is an independent company that provides prescription drug benefits administration on behalf of BlueChoice HealthPlan. For personal information about prescription drug coverage, please have your employees log in to My Health Toolkit®.

Vaccines

Where can you get your flu vaccine and other vaccines?

Effective immediately, your employees can get their seasonal flu vaccine covered at $0 copay through their pharmacy benefit by visiting any network pharmacy. Find a participating pharmacy within South Carolina or the entire U.S. Or, they can visit their primary care physician. If they don't have one, they can find one here.

Your employees can also visit a participating pharmacy within South Carolina or the entire U.S. to get some non-seasonal preventive care vaccines at a $0 copay. Below is a chart of these vaccines:

    Adults Children (birth to age 18)
Pneumonia   X X
Hepatitis A   X X
Hepatitis B   X X
Human Papillomavirus   X X
Varicella   X X
Measles, Mumps, Rubella   X X
Meningococcal   X X
Tetanus   X X
Tetanus, Diphtheria, Pertussis   X X
Haemophilus B     X
Diphtheria, Tetanus, Pertussis, Haemophilus B     X
Diphtheria, Tetanus, Pertussis, Inactivated Poliovirus     X
Diphtheria, Tetanus, Pertussis, Inactivated Poliovirus, Haemophilus B     X
Diphtheria, Tetanus, Pertussis, Inactivated Poliovirus, Hepatitis B     X
Haemophilus B, Hepatitis B     X
Measles, Mumps, Rubella, Varicella     X
Tetanus, Diphtheria     X
Meningococcal, Haemophilus B, Tetanus     X
Inactivated Poliovirus     X
Rotavirus     X
Zoster (Zostavax)*   X  
Zoster (Shingrix)**   X  
Tetanus, Diphtheria Toxoids   X  
Hepatitis A & B   X  

*This vaccine is only covered for those ages 50 and older.

**This vaccine is only covered for those ages 60 and older.