2020 Blue Cross and Blue Shield Service Benefit Plan - FEP Blue Focus
Section 5(f). Prescription Drug Benefits
Page 97
Section 5(f). Prescription Drug Benefits
Page 97
Benefits Description
Covered Medications and Supplies (cont.)
Note: We waive your cost-share for generic contraceptives and for brand-name contraceptives that have no generic equivalent or generic alternative, when you purchase them at a Preferred retail pharmacy.
You Pay
See pages 95 and 99
Covered Medications and Supplies (cont.)
- Intrauterine devices (IUDs)
- Implantable contraceptives
- Oral and transdermal contraceptives
Note: We waive your cost-share for generic contraceptives and for brand-name contraceptives that have no generic equivalent or generic alternative, when you purchase them at a Preferred retail pharmacy.
You Pay
See pages 95 and 99
Benefit Description
Over-the-counter (OTC) contraceptive drugs and devices, for women only, limited to:
Note: We provide benefits in full for OTC contraceptive drugs and devices for women only when the contraceptives meet U.S FDA standards for OTC products. To receive benefits, you must use a Preferred retail pharmacy and present the pharmacist with a written prescription from your physician.
You Pay
Preferred retail and overseas retail pharmacy: Nothing
Non-preferred retail pharmacy: You pay all charges
Note: See Section 5(i), page 110, for information on how to file claims for overseas services.
Over-the-counter (OTC) contraceptive drugs and devices, for women only, limited to:
- Emergency contraceptive pills
- Female condoms
- Spermicides
- Sponges
Note: We provide benefits in full for OTC contraceptive drugs and devices for women only when the contraceptives meet U.S FDA standards for OTC products. To receive benefits, you must use a Preferred retail pharmacy and present the pharmacist with a written prescription from your physician.
You Pay
Preferred retail and overseas retail pharmacy: Nothing
Non-preferred retail pharmacy: You pay all charges
Note: See Section 5(i), page 110, for information on how to file claims for overseas services.
Benefit Description
Immunizations when provided by a Preferred retail pharmacy that participates in our vaccine network (see below) and administered in compliance with applicable state law and pharmacy certification requirements. See pages 45 and 46 for specific coverage.
Note: Our vaccine network is a network of Preferred retail pharmacies that have agreements with us to administer one or more routine immunizations. Check with your pharmacy or call our Retail Pharmacy Program at 800-624-5060, TTY: 800-624-5077, to find out which vaccines your pharmacy can provide.
You Pay
Preferred retail and overseas retail pharmacy: Nothing
Non-preferred retail pharmacy: You pay all charges
Notes:
Immunizations when provided by a Preferred retail pharmacy that participates in our vaccine network (see below) and administered in compliance with applicable state law and pharmacy certification requirements. See pages 45 and 46 for specific coverage.
Note: Our vaccine network is a network of Preferred retail pharmacies that have agreements with us to administer one or more routine immunizations. Check with your pharmacy or call our Retail Pharmacy Program at 800-624-5060, TTY: 800-624-5077, to find out which vaccines your pharmacy can provide.
You Pay
Preferred retail and overseas retail pharmacy: Nothing
Non-preferred retail pharmacy: You pay all charges
Notes:
- You pay nothing for Influenza (flu) vaccines obtained at Non-preferred retail pharmacies.
- See Section 5(i), page 110, for information on how to file claims for overseas services.
Benefit Description
Diabetic Meter Program
Members with diabetes may obtain one glucose meter kit every 365 days at no cost through our Diabetic Meter Program. To use this program, you must call the telephone number listed below and request one of the eligible types of meters. The types of glucose meter kits available through our program are subject to change.
To order your free glucose meter kit, call us toll-free at 855-582-2024, Monday through Friday, from 9 a.m. to 7 p.m., Eastern Time, or visit our website at www.fepblue.org. The selected meter kit will be sent to you within 7 to 10 days of your request.
Note: Contact your physician to obtain a new prescription for the test strips and lancets to use with the new meter. Benefits will be provided for the test strips at Tier 2 (preferred brand-name) benefit payment levels if you purchase brand-name strips at a Preferred retail pharmacy. See page 99 for more information.
You Pay
Nothing for a glucose meter kit ordered through our Diabetic Meter Program
When obtained from any other source: You pay all charges
Diabetic Meter Program
Members with diabetes may obtain one glucose meter kit every 365 days at no cost through our Diabetic Meter Program. To use this program, you must call the telephone number listed below and request one of the eligible types of meters. The types of glucose meter kits available through our program are subject to change.
To order your free glucose meter kit, call us toll-free at 855-582-2024, Monday through Friday, from 9 a.m. to 7 p.m., Eastern Time, or visit our website at www.fepblue.org. The selected meter kit will be sent to you within 7 to 10 days of your request.
Note: Contact your physician to obtain a new prescription for the test strips and lancets to use with the new meter. Benefits will be provided for the test strips at Tier 2 (preferred brand-name) benefit payment levels if you purchase brand-name strips at a Preferred retail pharmacy. See page 99 for more information.
You Pay
Nothing for a glucose meter kit ordered through our Diabetic Meter Program
When obtained from any other source: You pay all charges
Covered Medications and Supplies - continued on next page