Capital Blue Cross has teamed up with Mark Cuban Cost Plus Drug Company 1 to give you greater access to many low-cost generic drugs. See what you can save!
When you create your account, add your Capital Blue Cross insurance card information to use your prescription drug benefits.
If you have questions or need help, please call the Member Services number on the back of your Capital Blue Cross ID card.
You will need the name of your current health plan found on your ID card.(example: Capital Blue Cross Medicare PPO)
To access pricing, login to your secure member account.
Search the Ideal Formulary for drugs included on the Capital Blue Cross formulary. This formulary applies to the following plans: Capital Blue Cross Select, Enhanced and Value PPO plans, and Capital Blue Cross | WellSpan Advantage, Advantage Plus, Value PPO and Inspire HMO plans, and BlueJourney Prime and Classic PPO plans, and Essential, Premier, and Value HMO plans, as well as our Capital Blue Cross PPO and HMO Group benefit plans.
Search the Value Formulary for drugs included in the Capital Blue Cross Medicare PPO Group benefit plans with Medical Option C coverage.
Add your prescriptions to see how much you will pay each month and save by either switching to a pharmacy that has lower prescription cost or finding a lower cost alternative.
Help with Drug Costs - See if you qualify for help paying for your prescription drugs.
Out of Network Pharmacy Information - How to get reimbursed for prescriptions filled at an out-of-network pharmacy.
General Transition Notice - Explanation of the transition process of your current drugs when you switch to a different health plan.
Drug Utilization Management - If required, this process will ensure you are getting the proper drugs for your diagnosed condition.
Vaccine Finder - Are you having a difficult time finding where you can get a flu shot or the shingles vaccine? Use the Vaccine Finder to search your specific areas for what pharmacies have certain vaccines available now!
Part B Step Therapy - A process used to try a lesser expensive drug before going with the top brand drug.
Medication Therapy Management is a free educational program to help control long-term conditions for members who have multiple chronic diseases.
Medicare Coverage Determination Form - Use this form when your doctor or pharmacist tells you a prescribed drug will not be covered by your plan.
Pharmacy Reimbursement Form - To request reimbursement for a drug purchased at an out-of-network pharmacy.
Our plan’s mail order service allows you to order at least a 30-day supply of a drug and no more than a 90-day supply.
Our primary mail order pharmacies options are listed below for your convenience.
To get information about filling your prescription by mail through Express Scripts Pharmacy, contact Express Scripts Pharmacy at 1.833.715.0946, (TYY users should call 711), 24 hours a day, 7 days a week. Or print and mail the Express Scripts mail order form.
To get information about filling your prescription by mail through Amazon Pharmacy, contact Amazon Pharmacy at 1.855.745.5725, (TYY users should call 711), 24 hours a day, 7 days a week.
To get information about filling your prescription by mail through Walgreens Mail Service, contact Walgreens Mail Service at 1.855.924.8421, (TYY users should call 711), 24 hours a day, 7 days a week. Or print and mail the Walgreens Mail Service order form.
For more information about our plan’s mail order service, please review Chapter 5 of your Evidence of Coverage booklet.
1 Mark Cuban Cost Plus Drug Company, PBC is contracted through Prime Therapeutics LLC to provide mail pharmacy services to members of Capital Blue Cross. On behalf of Capital Blue Cross, Prime Therapeutics LLC assists in the administration of our prescription drug program. Prime Therapeutics LLC is an independent pharmacy benefit manager.
Updated 9 января 2024 г.
Capital Blue Cross is a HMO, PPO Plan with a Medicare Contract. Enrollment in Capital Blue Cross depends on contract renewal. Care management services for certain products are provided by WellSpan Health.
® Central, a Medicare Advantage organization with a Medicare contract. Enrollment in BlueJourney Alliance (HMO SNP) depends on contract renewal. These plans are available to people meeting certain eligibility requirements, including verification that you have a qualifying specific severe or disabling chronic condition, or for 90 days or longer, have had or are expected to need the level of services provided in a long-term care (LTC) skilled nursing facility (SNF), a LTC nursing facility (NF), a SNF/NF, an intermediate care facility for individuals with intellectual disabilities (ICF/IDD), or an inpatient psychiatric facility, or that that your condition makes it likely that either the length of stay or the need for an institutional level of care would be at least 90 days.
You must be enrolled in Medicare Part B (Medical Insurance) and be entitled to Medicare Part A (Hospital Insurance) to enroll in this plan.
Members may enroll in the plan only during specific times of the year. Contact the plan for more information. The benefit information provided is a brief summary, not a complete description of benefits. Call member services for more information. You must continue to pay your Medicare Part B premium. Limitations, copayments, and restrictions may apply. Benefits, formulary, pharmacy network, premium, and/or copayments/coinsurance may change on January 1 of each year.
Healthcare benefit programs issued or administered by Capital Blue Cross and/or its subsidiaries, Capital Advantage Insurance Company ® , Capital Advantage Assurance Company ® , and Keystone Health Plan ® Central. Independent licensees of the Blue Cross Blue Shield Association serving 21 counties in Central Pennsylvania and the Lehigh Valley. Communications issued by Capital Blue Cross in its capacity as administrator of programs and provider relations for all companies.
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