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 Blue
RxSM
Blue Rx is a managed drug plan included with several of our health plans.
It’s a convenient program that helps members get all their medically
necessary prescription medications at the most economical price!
How It Works
Blue Rx includes managed care elements that balance two important goals:
providing access to necessary medications and encouraging the economical
purchase of those medications. The incentives built into this plan and
the information we provide help accomplish these goals. Here’s
how:
- Blue Rx encourages the use of generic drugs, unless an "A" rated
generic drug is not available. Members may choose to purchase
a brand-name drug even when a generic is available. However, the member
will usually pay a higher copayment or coinsurance amount and the difference
between the two drug prices.
- Blue Rx gives you lower costs because Wellmark has negotiated a pricing
structure through pharmacies that supports Blue Rx. When members use their ID cards at any of the participating
pharmacies, their claims will be processed electronically and they
will automatically get the lowest price available at that pharmacy.
Blue Rx features include:
- Nationwide pharmacy network - The Catalyst Rx network that supports Blue Rx is one of
the most expansive pharmacy networks in the country. Nationwide, more
than 59,000 pharmacies are part of our pharmacy network that supports Blue Rx.*
- No claims forms to fill out - When members present
their Wellmark ID card at participating pharmacies, their claims are submitted
automatically to us while their prescriptions are being filled! No
paper claims. No hassles.
- Cost Savings - By presenting their Wellmark ID to
the pharmacist before the prescription is filled, members
will ensure that they pay only their share of the costs. There’s
no need to second-guess the amount!
- Wellmark Drug List - Our Wellmark
Drug List, a comparative listing of drugs, helps manage the overall
cost of prescription medications by promoting the use of more cost-effective
drugs.
- Benefits at out-of-network pharmacies - Even if
an out-of-network pharmacy is used, members still have Blue Rx benefits.
However, these pharmacies do not have benefit information available.
The member will have to pay for the drugs at the time the prescription
is filled and will need to file the claims directly with Wellmark.
Wellmark will reimburse the member the amount we would have reimbursed
a participating pharmacy.
Please note: This information is only a summary of the benefits of Blue
Rx coverage from Wellmark Blue Cross and Blue Shield; it is to be used
for descriptive purposes only. Benefits and general provisions described
herein are subject to terms of the actual policy and benefits certificate.
For more information about any plans, contact
your local Farm Bureau agent.
*Catalyst Rx, 2nd Quarter, 2007
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