Comprehensive Major Medical (CMM)
With CMM, your health plan's deductible, coinsurance
and/or copayment apply to your prescription drugs. Refer to your health
plan's certificate or coverage manual for details about your prescription
drug coverage. The Wellmark Drug List can help you identify cost-saving
drugs.
How it Works
- Ask your physician if the drug is generic. If it isn't, ask
whether a generic equivalent drug is available.
- Choose a pharmacy that contracts with Catalyst Rx. More than 59,000
pharmacies throughout the United States contract with Catalyst Rx.*
- To find a participating pharmacy, locate a pharmacy using our
online
directory.
- Show your Wellmark
ID card to the pharmacist each time you have a prescription filled.
You will automatically get the lowest price available at
that pharmacy.
- Pay the pharmacist for the cost of the prescription. The pharmacist
will submit the claim for you.
- Receive reimbursement by mail. Wellmark will reimburse
you for covered prescription drug expenses, less deductible and coinsurance
amounts.
What You Get
1. Nationwide pharmacy network.
The Catalyst Rx network is one of the most
expansive pharmacy networks in the country.
2. No claim forms to fill out.
When you present your Wellmark ID
card at participating pharmacies, your claims are submitted automatically
while
your prescriptions are being filled! No paper claims. No hassles.
3. Cost savings.
Presenting your Wellmark ID to the pharmacist before the prescription is filled ensures that you
pay only your share
of the costs.
4. Wellmark Drug List.
Our drug list, a comparative
listing of drugs, helps manage the overall cost of prescription
medications
by promoting the use of more cost-effective drugs. Search
the Wellmark
Drug List.
5. Benefits at out-of-network pharmacies.
Even if an out-of-network
pharmacy is used, you still have benefits. However, these pharmacies
do not have
benefit information available. You will have to fill out and submit
a paper claim to Wellmark. Wellmark will be reimburse you for covered
prescription
drug expenses, less deductible and coinsurance amounts.
Who
Can Purchase
*Catalyst Rx, 2nd Quarter, 2007
Please note: This information is only a summary of the
benefits of CMM 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.
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