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2018 Blue Solutions Renewal Guide

Comprehensive coverage helps keep members healthier With coverage included for prescription drugs, adult and pediatric vision, and pediatric dental, Blue Solutions plans help members better manage their total health — which in turn helps reduce your overall health care costs. Prescription drug benefits encourage safe, effective, and affordable use Our prescription drug benefits, administered by FutureScripts®, provide members with access to covered medications, while helping to manage costs for you and members alike. Value Formulary • Our plans use this new comprehensive list of generic, brand, and specialty drugs • Drives more cost-effective utilization • Drugs may not be covered when there are good alternatives used to treat the same condition at a lower cost Preferred Pharmacy Network ZOOMcatalog • Feature of our Silver (excludes EPO) and Bronze plans and Keystone HMO Proactive plans • Includes more than 50,000 pharmacies, including CVS, Walmart, Target, and many independent pharmacies • Does not include Rite Aid and Walgreens pharmacies* Low-Cost Generic Copay • Included in Keystone HMO Proactive plans • Allows members to pay even less than standard generic cost-sharing for some generic drugs • Members pay $4 for certain generics at participating retail pharmacies Specialty Drug Cost-Share • Specialty drugs treat complex or chronic diseases, such as rheumatoid arthritis, hepatitis C, and certain cancers • Require special handling, administration, and monitoring • Designated cost-share helps manage the increasingly high costs for specialty drugs, which are typically used by a small number of members VALUE MAIL SPECIALTY DRUG ORDER * The Preferred Pharmacy network includes more than 50,000 pharmacies. With plans that use the Preferred Pharmacy network, filling a prescription at a non-participating pharmacy such as Rite Aid or Walgreens is considered out of network, and members must pay the total cost up front. They may be able to get reimbursed for part of this cost, but they will need to submit a claim and reimbursement will be at a lower rate. EASY TO USE ONLINE TOOLS FORMULARY CONVENIENCE BRIOVA Rx® SA VINGS WITH 68K+ PHARMACIES NATIONWIDE Find a network pharmacy, estimate drug costs, review claims, and submit mail-order requests at ibxpress.com Encourages members to consider generic drugs and lower cost brand medications Free home delivery for medications members take regularly; some may get a 90-day supply for the cost of a 60-day supply Members receive support from pharmacists and nurses experienced in treating rare, complex, and chronic diseases All plans offer access to an extensive network of retail and independent pharmacies* 7


2018 Blue Solutions Renewal Guide
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