Your Prescription Drug Program
Administered by Blue Cross Blue Shield of Michigan
Obtaining Prescription Drugs from Participating Pharmacies
The Blue Cross Blue Shield of Michigan Prescription Drug Program:
Whether you take medication on an ongoing basis or you simply need a prescription filled from time to time, your Blue Cross Blue Shield of Michigan Prescription Drug Program offers important benefits, services and savings for you and your eligible dependents in three important ways:
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a network of pharmacies throughout Michigan
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a national network of participating pharmacies for prescriptions filled outside of Michigan
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a mail service prescription drug program that provides savings and convenient home delivery for your long-term prescription drug needs
Your prescription Drug Program (the Program) is administered by Blue Cross Blue Shield of Michigan. Medco Health is the provider of the mail service.
If you or an eligible family member needs to take a prescription drug on a short-term basis, (for example an antibiotic to treat strep throat), have the prescription filled at a participating pharmacy. Just present your Blue Cross Blue Shield of Michigan ID card and prescription(s) to the pharmacist. You'll be charged a single co payment (or coinsurance depending on your Plan) per covered prescription order or refill. You do not have to submit a claim form when you use a participating pharmacy.
To locate a participating pharmacy near your home or workplace, call your current Blue Cross Blue Shield of Michigan Customer Services toll-free number.
Out-of-State Pharmacies
The out-of-state pharmacy network includes all of the major chain pharmacies as well as thousands of independently owned pharmacies. To locate a pharmacy while traveling outside of Michigan, call your current Blue Cross Blue Shield Michigan Customer Service toll-free number.
How to Use the Retail Pharmacy Program
At Participating Pharmacies in or Outside of Michigan:
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Present your Blue Cross Blue Shield of Michigan ID card and prescription(s) to the pharmacist.
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You must provide the pharmacist with the patient's full name, date of birth (month and year) and his or her relationship to the subscriber.
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The pharmacist will use a computerized system to confirm your eligibility for benefits and tell you the correct amount to pay.
You will not have to file any claim forms for prescriptions filled at a participating pharmacy.
At Non-participating Pharmacies Outside of Michigan:
Pay the full price (100%) of the prescription and obtain a prescription drug receipt. Fill out a claim form, attach the receipt, and mail the form to Blue Cross Blue Shield of Michigan, P.O.Box 500, Detroit, MI 48231-0500. To obtain claim forms, call your current Blue Cross Blue Shield of Michigan Customer Services toll-free number.
Please note that your cost will usually be higher when you use a non-participating pharmacy.
EasyRx -- The Simple Way to use Your Mail Service Pharmacy
If you're taking medication on an ongoing basis, such as medication to reduce blood pressure, or treat asthma, diabetes, or any chronic health condition, you could be using the Mail Service pharmacy.
With the Mail Service...
- you can be assured that we follow strict quality and safety controls for every prescription filled
- our pharmacies are staffed with highly trained, registered pharmacists
- a registered pharmacist is available for emergency consultations 24 hours a day, seven days a week by contacting Medco Health (Mail) Member Services
- and to make the process simpler and quicker, there's EasyRx. EasyRx is our name for how you may order new and refill prescriptions from the mail service pharmacy. Just follow the EasyRx steps.
Here's How:
- Ordering new prescriptions - Ask your doctor to prescribe needed medication for up to the number of days permitted by your Plan, plus refills, if appropriate. Mail your prescription and correct co payment in the special order envelope. Or, ask your doctor to call 1-888-EASYRX1 (1-888-327-9791) for instructions on how to fax the prescription. Please remember to give your doctor your member ID number.
- Refilling your medication - To be sure you never run short of your prescription medication, you should reorder on or after the refill date indicated on the refill slip or when you have fewer than 30 days of medication left.
To order online: Log on to our web site at www.medcohealth.com. Have your member ID number, the prescription number (it;s the 12-digit number on your refill slip), and your credit card ready.
To order by phone: Call Medco Health (Mail) Member Services and use the automated refill system. Have your member ID number and refill slip with the prescription information ready.
To order by mail: Simply mail your refill slip and co payment in the special order envelope.
- Delivering your Medication - Your order will be processed promptly upon receipt ny the pharmacy and your medication will be sent to you via U.S. Mail or UPS along with instructions for future refills, if applicable. After processing, please allow approximately one week for normal mail delivery. if you are mailing your new or refill prescription requests, please include your co payment and allow up to 14 days for delivery.
A leaflet explaining the purpose of the drug, correct dosages and other helpful information may also be included.
- Paying for your Medication - You may pay by check or money order or you may authorize billing to your credit card; MasterCard, VISA, Discover/Novus, American Express, or Diners Club. Please do not mail cash.
Generic Drugs
Generic drugs contain the same active ingredients and are equivalent in strength and dosage to the original brand-name product. Yet a generic drug generally costs less than a brand-name drug. Ask your doctor to prescribe generic drugs whenever appropriate.
Sometimes your physician may prescribe a medication to be dispensed as written when a preferred brand generic alternative is available. As part of your prescription drug plan, the pharmacist may discuss with your physician whether an alternative drug might be appropriate for you. Let your physician know if you have a question about a change in prescription or prefer the original prescription. Your physician always makes the final decision on your medication.
The generic name of a drug is its chemical name. The brand-name is the trade name under which the drug is advertised and sold.
Drug Utilization Review: Safe and Appropriate Use of Medications
Under this program, you and your covered dependents benefit from a comprehensive medication safety review. When your prescriptions are filled through the mail service pharmacy or participating retail pharmacies they are reviewed for any potential drug interactions based on your personal medication profile. This is especially important if you take many different medications, or see more than one doctor. If there is a question about your prescription, your pharmacist may contact your physician before dispensing the medication.
Other Important Features of your Prescription Drug Program
Your program has been designed to provide you with the quality of care you expect and the service you deserve -- whether it's keeping a profile of your medication history, providing a toll-free number to speak with a pharmacist or simply advising you of any program changes in a timely manner.
Health and prescription information of members and dependants is used by Medco Health and its affiliates to administer your health benefits drug programs. As part of this administration, Medco Health generally reports that information to the administrator or sponsor of your health care plan. Medco Health also uses the information and prescription data gathered from claims submitted nationwide for reporting and analysis without identifying individual patients.
Answers to your Questions
How do I order additional mail service envelopes?
Simply call Medco Health Member Services at 1-800-903-8346. The requested materials will be mailed to you right away.
How do I know if my drug is covered under the program?
Check with Blue Cross Blue Shield of Michigan Customer Service for information about covered and excluded medications.
What if I have a question about my mail service medication?
If you ever have a question, please call Medco Health Member Services at 1-800-903-8346. A registered pharmacist is available to answer any questions about your medication. Please also note that an informational leaflet is included with most new prescriptions ordered from Medco Health explaining the purpose of the drug, correct dosages and other helpful information.
How long will it take to receive a Medication ordered through Mail Service?
If you phoned in a refill order by calling 1-800-903-8346, your medication will be processed promptly and will be sent to you via U.S.Mail or UPS along with instructions for future refills, if applicable. Once processed. please allow approximately one week for normal delivery to your home. If you mailed in your order, please allow up to 14 days for delivery from the time you mailed your prescription.
What if I send in the Wrong Co Payment?
If there is a balance due, an invoice will be included with your prescription order. If you overpaid, your account will be credited.
How do I find a Participating Pharmacy?
Contact Blue Cross Blue Shield of Michigan Customer Service and they will be able to provide you with the names and addresses of pharmacies within your area.
Are there differences between brand and generic drugs?
The brand-name drug is the product name under which a drug is advertised and sold. Generic equivalent medications contain the same active ingredients and are subject to the same rigid FDA standards for quality, strength and purity as their brand-name equivalents. Generally, generic drugs are less expensive than brand-name drugs.
What happens if I do not receive my prescription in 14 days?
If the mail service pharmacy is unable to fill and ship your prescription in 14 days, you will be notified by Medco Health Member Services as to the delay. In rare cases prescriptions do get lost in the mail. If you do not receive your prescription within 14 days or do not receive a call from Member Services, please call mail service Member Services at 1-800-903-8346. If the prescription was lost in the mail, the mail service pharmacy will call your physician to verify the prescription and then ship the prescription immediately.
If my plan covers insulin and insulin syringes, can I order insulin and insulin syringes through the mail?
Yes. Insulin and insulin syringes are available through mail service. For safety in shipping the insulin, the mail service pharmacy packages insulin according to the manufacturer's guidelines. The mail service pharmacy also makes accommodations for changes in climate by using insulated packaging and cold packs when necessary.
How can I be sure to get a 90-day supply through the mail?
Simply have your doctor write the prescription for a 90-day supply plus refills. The prescription should also include: exact quantity to be dispensed, the doctor's DEA number and name, daily directions, drug name and strength and the exact number of refills.
Note: Certain controlled substances and several other prescribed medications may be subject to other dispensing limitations (e.g. quantities dispensed) and the professional judgment of the pharmacist. If you have any questions about your medication, please call Medco Health (Mail) Member Services at 1-800-903-8346.
Is if safe to order my medication through mail service?
Yes. Every prescription you order is reviewed by a team of licensed pharmacists who carefully check the prescription against your drug history profile. The prescription is verified by the mail service quality control department to make sure it is accurate in product, quantity, and strength.
Member Services
If you have any questions about your Retail Prescription Drug program, please call your current Blue Cross Blue Shield of Michigan Customer Service toll-free number.
If you have questions about your Mail Service program, please call:
1-800-903-8346
Monday-Friday, 8am - Midnight
Saturday, 8am- 6pm Eastern Time
If necessary, a registered pharmacist is available for emergency consultations 24 hours a day, seven days a week by calling the toll-free Member Services number above.
Special Services
The TDD number for the hearing impaired id 1-800-759-1089.
Note: Those with vision impairments may request Braille labels for their medication containers when ordering from Medco Health.
Medco Health on the Internet
Medco Health's Internet web site, www.medcohealth.com, provides the following services 24 hours-a-day, 7 days-a-week:
- Member can request mail order refills
- Member can check on the status of mail order prescriptions
- Member can place orders for additional mail order envelopes
- Patient education brochures and medication tips are also available.