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Access Your Payment Options. Prescription drugs are a vital part of your health care coverage. Be sure to review your benefit materials for details. If you have any questions about your prescription drug benefits, call the number listed on your member ID card. A drug list is a list of drugs that are covered under your prescription drug benefit. How much you pay out of pocket is determined by whether your drug is on the list and at what coverage level, or tier.
A generic drug is often at the lower tier. See if your drug is covered. Some prescription drug plans may require you to pay more if you fill a prescription for a brand name drug when a generic equivalent is available.
This Member Pay the Difference encourages members to use drugs that are safe, work well and are cost effective. Health plans may administer medical and pharmacy coverage separately for select drugs. Some drugs are covered under your medical plan instead of your pharmacy benefits. These can include drugs that must be given to you by a health care provider. Examples of these drugs are contraceptive implants and chemo infusion. To use your benefits, simply find a local contracting pharmacy and show your member ID card.
Starting Jan. This includes in-depth consultations. These services would be covered under your medical benefits. The amount you pay would be the same as seeing a specialist, based on your benefits. Review available resources such as frequently asked questions, a glucose meter offer and pharmaceutical care management program information. If a drug is designated as a voluntary MID drug, a physician can choose to buy and bill, or have a specialty pharmacy assigned through Free Market Health.
Network physicians can also choose to buy and bill voluntary MID drugs, in which case reimbursement will be governed by previous bulletin communications. Highmark Blue Shield does not reimburse network physicians for products included in the Medical Injectable Drug Program. Contact Us. Provider Directory. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania.
Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Quick Links: Manuals. Highmark Provider Manual. Medical Policy Medical Policy.
Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Quick Links: Manuals. Highmark Provider Manual. Medical Policy Medical Policy. Medical Policies. Medicare Advantage Medical Policies. Requiring Authorization. Pharmacy Policy Search. Message Center.
Manuals Highmark Provider Manual. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania.
Quick Links: Manuals. Highmark Provider Manual. Medical Policy Medical Policy. Medical Policies. Medicare Advantage Medical Policies. Requiring Authorization.
Pharmacy Policy Search. Message Center.
WebSpecialty Drug List - English; Specialty Drug List - Spanish; With CarelonRx Specialty Pharmacy, you get: Free shipping with confidential, on-time delivery Order your medicine . WebMedical Injectable Drug Program. On January 1, , Highmark Blue Shield ended its exclusive arrangement with Alliance Rx Walgreens Pharmacy and will be utilizing Free . WebHighmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus .