Blue Rx^SM Preferred

Blue Rx Preferred 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 Preferred 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 Preferred 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 Preferred gives you lower costs because Wellmark has negotiated a pricing structure through the member pharmacies that participate in the Catalyst Rx network that supports Blue Rx Preferred. 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 Preferred features include:

• Nationwide pharmacy network - The Catalyst Rx network that supports Blue Rx Preferred is one of the most expansive pharmacy networks in the country. Nationwide, more than 59,000 pharmacies are part of the pharmacy network that supports Blue Rx Preferred.*
• 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 Preferred 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 Preferred 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, benefits certificate, or coverage manual.

*Catalyst Rx, 2nd Quarter, 2007

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Wellmark Blue Cross and Blue Shield is an Independent Licensee of the Blue Cross and Blue Shield Association doing business in Iowa and South Dakota. Blue Cross®, Blue Shield®, and the Cross® and Shield® symbols are registered marks of the Blue Cross and Blue Shield Association, an Association of Independent Blue Cross and Blue Shield Plans.