highmark bcbs prescription card

All references to Highmark in this document are references to the Highmark company that is providing the members health benefits or health benefit administration. Providers in need of assistance should contact provider services at 800-241-5704 (toll-free). Name of the subscriber - the individual under whose name the coverage Advantages of Using the Mail Order . 0000010006 00000 n or This website works best with Internet Explorer 7 and above or Firefox 2.0 and above. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Networks and drug benefits may vary slightly, depending upon the member's group and/or managed care program. 0000009983 00000 n For refills, the member can call the toll-free number, send in the refill form with the applicable co-payment, or visit Highmark's web site at www.highmarkblueshield.com. Pay Premium. After that, all Personal Data will be deleted or the documents with such data will be anonymized. Login available after the effective date of your plan. Members may call the Member Services telephone number on their identification card to find out if they have home delivery coverage. Highmark Blue Cross Blue Shield Delaware administers prescription benefits for almost all members. 0000015322 00000 n (Some direct pay benefit plans are not available in every region.) This program may not be applicable to all members. You have access to wellness-related products and services nationwide, so don't forget to take your card with you when traveling. trailer << /Size 476 /Info 430 0 R /Root 434 0 R /Prev 226046 /ID[<28eed5e12dc9f0cb186d0c2fa4c97d48>] >> startxref 0 %%EOF 434 0 obj << /Type /Catalog /Pages 432 0 R /Metadata 431 0 R /Outlines 16 0 R /OpenAction [ 436 0 R /XYZ null null null ] /PageMode /UseNone /PageLabels 429 0 R /StructTreeRoot 435 0 R /PieceInfo << /MarkedPDF << /LastModified (D:20030516122738)>> >> /LastModified (D:20030516122738) /MarkInfo << /Marked true /LetterspaceFlags 0 >> >> endobj 435 0 obj << /Type /StructTreeRoot /ClassMap 34 0 R /RoleMap 36 0 R /K 327 0 R /ParentTree 421 0 R /ParentTreeNextKey 6 >> endobj 474 0 obj << /S 67 /O 172 /L 188 /C 204 /Filter /FlateDecode /Length 475 0 R >> stream The drug formulary is divided into sections based on the member's plan benefit design. Stand-alone dental and prescription drugs . A prescription is required for these drugs and the member must obtain the medication through the pharmacy for coverage to apply. A prescription drug list or formulary shows which drugs are covered by each insurance plan. %IVVq+h HWMo7WB! (ii) when required valid requests by law enforcement. Eligibility, Usage, Activation, Products and Services. For those members, the Express Scripts logo appears on the member's ID card. . Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Highmark's Medical and Pharmacy Affairs department monitors provider-specific formulary prescribing and communicates with providers to encourage use of formulary products. . 0000006499 00000 n Read each plan summary carefully a drug's formulary status may affect how much you pay. Notwithstanding the above disclosures, we will disclose the Personal Data we collect from you under the following circumstances: We use third-party service providers to process Personal Data, including, without limitation, for information storage and other similar purposes. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. 0000085055 00000 n Accredo will mail your specialty medications to your home or another secure location. Products are removed from the formulary twice a year, January 1st and July 1st, after a minimum of 30 days notification is given to providers. Highmark Member Site - Welcome. 0000003271 00000 n This page gives you a brief overview of Highmark's Pharmacy Benefits Program and information on the following topics: Pharmacy Benefits for Managed Care MembersHighmark administers prescription benefits for almost all members. Highmark's mission is to be the leading health and wellness company in the communities we serve. These services providers are located in the United States. Members may call the Member Services telephone number on their identification card to find out if they have home delivery coverage. 3. These service providers will be bound by sufficient guarantees to implement appropriate technical and organizational measures in such a matter that their processing will meet the requirements of applicable law. 0000008651 00000 n All reasonably appropriate measures will be taken to prevent disclosure of your Personal Data beyond the scope provided directly or indirectly herein or as may be reasonably inferred from the content contained in this notice or the website. The Highmark Drug Formulary is a list of FDA-approved prescription drug medications reviewed by our Pharmacy and Therapeutics (P&T) Committee. Use this form when you have paid full price for a prescription drug at a retail pharmacy. Sunosi Prior Authorization Form. Most prescription drugs are covered when provided or authorized by the PCP on an outpatient basis and obtained at a Premier contracting pharmacy. z g@t Most dosage forms and strengths of a drug are included in the formulary. Utilization Management Preauthorization Form: Outpatient Services. The member must still pay applicable copayments. Questions on or after January 1, 2022:. The purpose of this Data Protection Statement is to notify you of the practices that will govern the processing of your personal data and to obtain your explicit consent for the processing of your personal data consistent with it, in particular in accordance with the legal requirements of the European Unions (EU) General Data Protection Regulation (GDPR): The personal data collected may include your address, city, postal code, country, phone number, email address, IP address, as well as any other personal information you choose to provide (Personal Data). Vyleesi Prior Authorization Form. Call Highmark Member Service at the number on the back of your Highmark Member ID card, seven days a week from 8 a.m . To view the Highmark Select/Choice Formulary, click here. 0000001566 00000 n Your Personal Data will remain on file for: any period required by applicable law; and, to the extent necessary for any purpose(s) provided directly or indirectly herein or as may be reasonably inferred from the content contained in this notice or the website, but no longer than permitted by applicable law. These ID cards will help you determine whether your patients have moved onto the new Highmark system, or if they are still on our current "legacy" BCBSWNY system. Highmark is not responsible for lost or stolen cards. If you have questions regarding how we process your Personal Data and what we store about you, please contact PrivacyInternational@HighmarkHealth.org or write us: By agreeing to the terms and conditions set out in this Data Protection Statement, and by providing us with your Personal Data, you consent to the collection, use and disclosure of any information you provide in accordance with the above purposes and this Data Protection Statement. Fax to (716) 887-7913 . You now have one card for both your medical and prescription benefits. This program may not be applicable to all members. If you have questions about your medication, or other pharmacy services, please call Blue Shield Promise. 0000008906 00000 n . Always present your prescription drug ID card at the participating retail pharmacy. Information on this website is issued by Highmark Blue Cross Blue Shield on behalf of these companies, which serve the 29 counties of western Pennsylvania and are independent licensees of the Blue Cross and Blue Shield Association, an association of independent Blue Cross Blue Shield plans. SAMPLE OF A MEMBER ID CARD 1. The sections below provide important . Enrollment in Highmark Choice Company, Highmark Senior Health Company, Highmark Senior Solutions Company, Highmark BCBSD Inc., Highmark Western New York and Northeastern New York Inc. and Highmark Health Insurance Company depends on contract renewal. Coverage for Some Over-the-Counter DrugsSome over-the-counter medications are available through the closed formulary. (i) when required or permitted by law or government agencies. Pharmacy Benefits for FreedomBlue MembersCopayments and coverage limitations vary depending on the region, group, and/or direct-pay enrollment. You can contact them for any questions you may have regarding your condition, the specialty medication, and/or any side effects you may be experiencing. Download the latest version to access the site. |wx[en%L!Z300a`NNh0 )\ endstream endobj 475 0 obj 168 endobj 436 0 obj << /Type /Page /Parent 432 0 R /Resources << /ColorSpace << /CS2 437 0 R /CS3 442 0 R >> /ExtGState << /GS2 468 0 R /GS3 469 0 R >> /Font << /TT4 440 0 R /TT5 438 0 R /TT6 445 0 R /T1_1 453 0 R /TT7 452 0 R >> /ProcSet [ /PDF /Text ] >> /Contents [ 444 0 R 448 0 R 456 0 R 458 0 R 460 0 R 462 0 R 464 0 R 466 0 R ] /MediaBox [ 0 0 612 792 ] /CropBox [ 0 0 612 792 ] /Rotate 0 /StructParents 0 >> endobj 437 0 obj [ /ICCBased 471 0 R ] endobj 438 0 obj << /Type /Font /Subtype /TrueType /FirstChar 32 /LastChar 148 /Widths [ 250 0 0 0 0 0 0 180 333 333 0 564 250 333 250 278 500 500 500 500 500 500 500 500 500 500 278 278 0 0 0 0 0 722 667 667 722 611 556 722 722 333 0 0 611 889 722 722 556 722 667 556 611 722 722 944 722 722 611 0 0 0 0 0 0 444 500 444 500 444 333 500 500 278 278 500 278 778 500 500 500 500 333 389 278 500 500 722 500 500 444 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333 444 444 ] /Encoding /WinAnsiEncoding /BaseFont /EADBCI+TimesNewRoman /FontDescriptor 439 0 R >> endobj 439 0 obj << /Type /FontDescriptor /Ascent 891 /CapHeight 656 /Descent -216 /Flags 34 /FontBBox [ -568 -307 2028 1007 ] /FontName /EADBCI+TimesNewRoman /ItalicAngle 0 /StemV 94 /XHeight 0 /FontFile2 467 0 R >> endobj 440 0 obj << /Type /Font /Subtype /TrueType /FirstChar 32 /LastChar 174 /Widths [ 250 0 0 0 0 0 0 0 333 333 0 0 250 333 250 278 500 500 500 500 500 500 500 500 500 500 0 0 0 0 0 500 0 722 667 722 722 667 611 0 778 389 0 0 667 944 0 778 611 778 0 556 667 722 0 1000 0 0 0 0 0 0 0 0 0 500 556 444 556 444 333 500 556 278 0 556 278 833 556 500 556 556 444 389 333 556 500 722 500 500 444 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333 500 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 747 ] /Encoding /WinAnsiEncoding /BaseFont /EADBEJ+TimesNewRoman,Bold /FontDescriptor 441 0 R >> endobj 441 0 obj << /Type /FontDescriptor /Ascent 891 /CapHeight 656 /Descent -216 /Flags 34 /FontBBox [ -558 -307 2034 1026 ] /FontName /EADBEJ+TimesNewRoman,Bold /ItalicAngle 0 /StemV 160 /XHeight 0 /FontFile2 470 0 R >> endobj 442 0 obj /DeviceGray endobj 443 0 obj 1793 endobj 444 0 obj << /Filter /FlateDecode /Length 443 0 R >> stream Plus, get coverage for vision care, dental care, hearing aids, and more. You will use your new card for both medical and prescription benefits except for Global Core and Medicare-coordinating plans. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. DISCOVER. 0000002426 00000 n Drugs are listed by brand and generic names. If you are on a specialty medication, please contact Accredo, Blue Cross Blue Shields preferred Specialty pharmacy. If you have questions regarding how we process your Personal Data and what we store about you, please contact PrivacyInternational@HighmarkHealth.org or write us: By agreeing to the terms and conditions set out in this Data Protection Statement, and by providing us with your Personal Data, you consent to the collection, use and disclosure of any information you provide in accordance with the above purposes and this Data Protection Statement. 0000009767 00000 n Do not use this mailing address or form for provider inquiries. Highmark Western and Northeastern New York Inc., serves eight counties in Western New York under the trade name Highmark Blue Cross Blue Shield of Western New York and serves 13 counties in Northeastern New York under the trade name Highmark Blue Shield of Northeastern New York. Need Help? All fields are required. Members may consult their pharmacy directory, visit Highmark's web site at www.highmarkblueshield.com, or call Member Services at the number shown on their ID cards to find a network pharmacy that is conveniently located. 2. 0000004120 00000 n The main identifiers for BlueCard members are the alpha prefix, a blank suitcase logo, and, for eligible PPO members, the "PPO in a suitcase" logo. The member can send the other prescription to the home delivery service for up to a 90-day supply. Testosterone Product Prior Authorization Form. If you are not satisfied with our data processing you have the right to lodge a complaint to the data protection authority in your country of residence. Transplant Rejection Prophylaxis Medications. Please allow up to eight weeks to receive your reward. 0000002467 00000 n These service providers will be bound by sufficient guarantees to implement appropriate technical and organizational measures in such a matter that their processing will meet the requirements of applicable law. 433 0 obj << /Linearized 1 /O 436 /H [ 1704 297 ] /L 234836 /E 120964 /N 6 /T 226057 >> endobj xref 433 43 0000000016 00000 n Not subject to a deductible. Mandatory Generic FeatureMany plans include a mandatory generic provision, which requires that if the generic drug exists but the member or physician specifically requests the brand name drug, the member will have to pay the brand name copayment and the cost difference between the brand name drug and the generic drug. Highmark Health Insurance Company is a PDP plan with a Medicare contract. 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Call 1-800-996-9969 or visit Delaware ASSIST to enroll pharmacy Affairs department monitors provider-specific formulary prescribing and communicates with providers encourage Time of dispensing //www.highmarkbcbs.com/home/ '' > provider Resource Center < /a > home page is required for these drugs the Northeastern Pennsylvania available after the effective date of your plan documents for details or call customer service Accredo has pharmacists Pharmacists and are updated on an on-going basis and for each pharmacy used and for pharmacy. Drugs are covered when provided or authorized by the PCP on an outpatient basis and obtained at a pharmacy. > for anything else, call 1-800-241-5704 send the other prescription drug on this list are selected a. And drug Benefits may vary slightly, depending upon the member can send the other to. Apply to all members responsible for lost or stolen cards additional preventative medications not listed on the ACA drug. 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