Brand Name Generic Name Important — Please Note
The Blue Cross mail service prescription drug
benefit does not cover drugs that do not require
a prescription, for example, aspirin, laxatives,
vitamins, drugs used for cosmetic purposes
(such as Propecia and Renova) and non-FDA
pharmaceutical guidelines and manufacturers
packaging, there are dispensing limitations on some
medications. In addition, some medications may
require prior authorization before they may be
dispensed. For the most current and complete list
Glucophage metformin Glucotrol glipizide
regarding quantity limitations and medications
requiring prior authorization please visit our Web
Medications such as amoxicillin or other antibiotics
prescribed by your doctor for short-term illnesses
are best obtained through your local pharmacy.
Prescriptions for Class II narcotics such as Ritalin
and other controlled substances are subject to
stricter regulations than other medications and
should not be obtained through mail service.
This brochure only highlights your mail service
prescription drug program. Refer to your Certificate
or benefit booklet for benefit information. In case of
any discrepancy between this brochure and the legal
documents describing the plan, the legal documents
If You Have Questions
Trental pentoxifylline If you have questions on cost or benefit coverage,Tylenol with codeine
call the Blue Cross Prescription Drug Inquiry Unit
at (800) 423-1973. Customer service representatives
are available 7:00 a.m. to 11:00 p.m. Monday
through Friday, 7:30 a.m. to 8:00 p.m., Saturday and
Sunday, Central Time. Have your Blue Cross ID
card handy when you call. To determine whether a
drug is on the formulary, visit our Web site at
As always, you should discuss with your physicianquestions or concerns about any drugs you are taking.
A Division of Health Care Service Corporation, a Mutual Legal Reserve Company, an Independent Licensee of the Blue Cross and Blue Shield Association
Your doctor can determine whether a generic drug isappropriate for you. Bringing Maintenance When Ordering Medications Save When You Use Generic Drugs Medications To Your Door for the First Time
Many people rely on prescription medications to stay healthy
• Ask your doctor for a new written prescription for each
Talk to Your Doctor and Pharmacist
and productive. But frequent trips to the pharmacy can be
medication you want to order to be delivered to your home.
Your doctor uses clinical knowledge and judgment to
costly and inconvenient. Fortunately, as a member of Blue
If you are starting a new medication, ask your doctor for two
prescribe drugs that meet your needs. The next time your
Cross and Blue Shield of Illinois you have a mail service
doctor writes you a prescription, ask if a generic is
prescription drug benefit if you or a dependent are on a
available. Generic drugs are widely recognized as
• one for a starter supply for up to 34 days that you can fill
effective medications. You can expect the same clinical
results as brand name drugs. When you are purchasing a
This benefit saves you time and money. You can:
• the second for up to a 90-day supply of the medication to
prescription, indicate that you would like a generic drug.
• take advantage of our discount arrangement with
be mailed to your home. To take full advantage of the
program, your 90-day prescription should be written
Frequently Asked Questions
• purchase maintenance medication every 90 days
Are generic drugs safe?
• We recommend that you take the medication for two weeks
Yes. The U.S. Food and Drug Administration (FDA)
• enjoy the convenience of mail service.
before sending the prescription for the larger supply to
must review and approve generic drugs before they are
For Prescription Drug Card Program members:
the mail service pharmacy. Your physician may want to
made available to the public. Plus, generic drugs must
monitor your initial reaction and response to the medication.
As determined by your specific health care benefits plan, you
have the same active ingredients as their comparable
• Ask your doctor whether you can use a generic medication
brand name drugs, which have years of testing and
if you are not currently doing so. The generic name of a drug
• a fixed dollar copayment depending on whether
is its chemical name. Generic drugs meet the same strict
your medication is generic, formulary brand or
requirements of the U.S. Food and Drug Administration
Why do generic drugs cost less?
(FDA) as brand drugs, but are considerably less expensive.
Generic drugs tend to cost less than the equivalent brand
• a coinsurance amount that is lowest for generic
name drug because the companies that make them do
• Complete the registration and prescription order form
not have to recover the costs of research and
enclosed in the packet with this brochure. Include
information for all your eligible dependents, even if they arenot currently taking medications. (Please note you need to doIs there a generic drug available for my condition?
• a combination of fixed dollar amounts and coinsurance. this one time only and not with each refill order.) Remember
Most likely. Almost 50 percent of all prescriptions are
to enclose all required information, including your member
For BlueSCRIPT members: The Blue Cross home
ID number, PCN number (lower right face of ID card) and
delivery prescription drug benefit offers you even more
your group number as they appear on your ID card. A Good Choice
convenience with medications delivered to your door.
Your doctor will determine the appropriate medication
The electronic claims processing service automatically
• Determine your total copayment/coinsurance cost and
for you. You should always ask if a generic version is
calculates the discounted price available to you as a
enclose it. You can pay by credit card, debit card, check or
available for your prescription. Remember, you get a
Blue Cross member. You are responsible for the appropriate
money order. Do not mail cash. If you have questions about
drug with the same active ingredients as the brand name
amount based on your prescription drug benefit.
your share of the cost, refer to your health care benefits plan
or call the Blue Cross Prescription Drug Inquiry Unit at(800) 423-1973.
On the next page are just a few of the most commonlyprescribed brand name drugs and their generic
• Mail the prescription(s) with your completed order form,
equivalents. Ask your physician to approve the generic
including payment information, in the enclosed
equivalent whenever possible by writing the generic
pre-addressed envelope. Remember to include postage.
blue cross and blue shield of texas mail order form — primemail® pharmacy iNstructioNs: Please PrINT in CAPITAL letters using black ink only. Fill in the applicable ovals completely ( ). For information about your pharmacy benefits, to preregister or to download additional order forms or a physician fax form, visit the Blue Cross and Blue Shield of Texas Web site at www.bcbstx.com
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