Female pharmacist wearing a mask sorting medications

New Blue Cross Pharmacy Partnership Adding Value, Managing Costs

The prescription drug coverage you receive from Blue Cross Blue Shield of Michigan and Blue Care Network may be the part of your health care plan that you and your employees use the most often.

To add more value – and to help you and your employees manage costs – we at Blue Cross and BCN are making improvements to prescription drug plans that you’ll see beginning Jan. 1, 2022. In January, Blue Cross and BCN will also begin a new partnership with OptumRx as its pharmacy benefits manager.

We will continue to provide employees of businesses like yours with access to medications from a large nationwide pharmacy network, including 2,300 pharmacies in Michigan and 65,000 pharmacies across the country. The improvements will strengthen our ability to bring you affordable, creative solutions for improving care.

Blue Cross has been communicating with you and your employees about the changes that we’re making by sending group contacts and members letters and emails.

“When your employees go to pick up their prescriptions – or have their medications delivered to their homes – they’ll have confidence that their prescription drug coverage will help them get the medicine they need,” said Atheer Kaddis, vice president of Pharmacy Services at Blue Cross. “Blue Cross and Blue Care Network have worked hard to give your business and employees holistic coverage for smarter, better health care by integrating pharmacy and medical benefits in one plan.”

Here’s how this new partnership will benefit you and your business:

  • Our lowest net cost strategy
  • More flexibility in benefit structure
  • Improved prescription drug pricing and rebates for all commercial individuals and group businesses as of Jan. 1, 2022
  • Access to a robust nationwide pharmacy network
  • A single health care solution for you and your team: one ID card, one account, one app and one customer service team

Here are some additional changes to be aware of:

  • Each member enrolled in a health plan with pharmacy benefits will receive a new member ID card before the end of the year, to use starting Jan. 1.
  • OptumRx will become the new home delivery pharmacy starting Jan. 1. Most home delivery prescriptions will automatically transfer to OptumRx, but some members may need to see their doctors for new prescriptions to continue to receive them through the mail. That’s the case if their prescription is expired or has no remaining refills, or if their medicine is a controlled substance.
  • Online member account pharmacy pages at bcbsm.com and in the Blue Cross Blue Shield of Michigan mobile app will be updated.

“Our low net cost strategy helps manage the constantly rising cost of prescription drugs,” said Kim Foerster, Pharmacy Account Management director at Blue Cross. “We prioritize proven generics and lower cost brand-name drugs over those that might come with higher manufacturer rebates, but still higher cost in the end. We use this approach to evaluate prescription drugs from generic antibiotics to biosimilars of high-cost specialty drugs. This strategy helps us manage drug costs for you, while still providing options to treat our members’ health conditions.”

If you have questions about our pharmacy plan improvements, call your Blue Cross and BCN sales representative or contracted agent. For more information about prescription drug benefits offered by Blue Cross, visit bcbsm.com/groupRx.

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Photo credit: Getty Images

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