BCBSGa Pharmacy Program - HMO and POS Members

• HMO and POS Members
• PPO Members

HMO and POS members have prescription drug coverage through an extensive pharmacy network that includes select local pharmacies and many national chains. Coverage is provided according to our Preferred Drug Formulary for prescriptions written by a network physician and filled at a network pharmacy.

Many employers allow their associates to use our mail-order pharmacy benefit. Simply check your ID card to determine if this benefit is available for you. If applicable, click here for direct access to order refills, print forms and obtain other helpful information.

Please check your Benefit Summary or Contract Booklet to be sure that you have prescription drug coverage through BCBSGa.

1. How do I get prescriptions filled through a mail order pharmacy?

First time mail order customers should ask their doctor for a written prescription for a 30, 60 or 90 day supply (as defined by your plan), plus refills when appropriate. Fill out a mail order form and return it to PrecisionRx at P.O. Box 961025, Fort Worth, Texas, 76161-9863. Their toll-free number is (866) 274-6825. You may order refills via their Web site at precisionrx.com. The delivery of your prescriptions will take 10-14 calendar days.

You may contact customer care by calling 1-(866)-274-6825
Monday-Friday: 6 AM-8 PM ET
Saturday: 7 AM- 6 PM ET

Special Note: Please confirm with your employer or review your Certificate Booklet to ensure you have the mail order pharmacy benefit. Mail order is available for maintenance drugs only, as classified by the Federal Data Bank.

2. What is the difference between generic and brand name drugs and how does that difference affect my benefits?

Brand name drugs are those drugs that are marketed under a specific trade name by a pharmaceutical manufacturer. In most cases, these drugs are still under patent protection, meaning the manufacturer is the sole source for the product. Generic drugs are safe, effective and equivalent to brand name medications that may cost considerably less than the brand name medications. Generic drugs must meet the same high standards of quality as brand name drugs and are formulated to have the same effect in the body as the brand name version. Generic drugs often become available when a brand name drug's patent expires.

The difference in your benefits is the amount of your copay. Generally, the cost of your copay for generic drugs is less than that of brand name drugs.

3. Can I get reimbursed for drugs I got from a pharmacy not in the network?

It will cost you more if you go to an out-of-network pharmacy. Take a claim form with you to the out-of-network pharmacy. If you need a claim form, simply download from our Forms section of this Web site. Once completed, fax the claim form to 1.877.868.7950 or by mailing to:

BCBSGa, PO Box 9907, Columbus, GA 31908-6007

4. If I am going to be out of town for an extended time, how do I get an extra supply of drugs to cover me through that period?

If you are out of state and you need medicine, call the customer service number on your member ID card to find a nearby participating national pharmacy. If there is not a national pharmacy, pay for the prescription and send us a claim form. If you are planning to go out of the country, go to your local network pharmacy prior to your trip. Pay for the extra supply and send us a claim form. If you should need to purchase drugs while out of the country, pay for drug, and send us a copy of the letter indicating your prescription, receipt and a claim form.

5. What is a drug formulary (or preferred drug list) and how does that affect me?

A prescription drug formulary is used to help your doctor make prescribing decisions. This list of drugs is updated quarterly by a committee of doctors and pharmacists so that the list includes drugs that are safe and effective in the treatment of disease. The goal of the formulary list of prescription drugs, as established for the Pharmacy Program, is to identify and promote prescription drugs which are therapeutically appropriate and cost-effective.