highmark bcbs prescription card

0000001211 00000 n 0000015322 00000 n DISCOVER. Pharmacists available 24/7 to answer your questions. You now have one card for both your medical and prescription benefits. 0000082377 00000 n A member can verify his or her particular drug coverage by calling Member Service at the telephone number shown on the member's ID card or by visiting Highmark's Medicare-Approved formulary site at: http://highmark.medicare-approvedformularies.com. 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. Have your member ID card handy, Up to a 90-day supply of each covered medication (compare to a typical retail 30-day supply), Pharmacists available 24/7 to answer your questions, Eliminates the need to travel to a pharmacy, Refill requests online, by mail, or by phone anytime, day or night, Some plans may have an expanded preventive drug list. This information will be used for purposes of performing services to, or on behalf of, our enterprise customers and prospective customers as part of and in relation to matters regarding our provider, health plan, and subsidiary enterprise care delivery, administration and operations. Regular; Large; Largest; Font size dropdown. Not subject to a deductible. 0000006046 00000 n 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. . Plus, get coverage for vision care, dental care, hearing aids, and more. Please allow up to eight weeks to receive your reward. 0000013562 00000 n 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 0000003271 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. 0000008651 00000 n With Highmark Blue Cross Blue Shield of Western New York, getting and staying healthy is now more affordable with our nationwide wellness debit card benefit. If you have questions about your medication, or other pharmacy services, please call Blue Shield Promise. Highmark Member Site - Welcome. Home page. 0000006767 00000 n Your email address and phone number may be used to contact you. The Highmark Drug Formulary is a list of FDA-approved prescription drug medications reviewed by our Pharmacy and Therapeutics (P&T) Committee. Select Language ; Select Language; Font size dropdown. The Hi- Mark Bar 3229 Riverside Dr. Cincinnati, OH 45226 East End 513-492-7119 Order Carryout Order Delivery Wednesday Trivia 7pm / Hi- Mark Trivia hosted by Moichman Current Hours Last Updated 10:15am 6/7/2022 Outdoor Dining, Indoor Dining, Carryout and Delivery Monday-Thursday 4pm-11pm Friday 4pm-12am Saturday Noon-12am Sunday Noon-10pm. 0000011828 00000 n Please review your benefit summary documents or contact customer service, Nearly 80% of prescriptions filled in the U.S. are generics, They work just like brand-name medications and have the same active ingredients, Many generics are manufactured by the same company that makes the brand-name medications, Generics are of the same quality, strength, and purity standards as non-generic. 2022Highmark Blue Cross Blue Shield of Western New Yorkis a trade name of Highmark Western and Northeastern New York Inc., an independent licensee of the Blue Cross Blue Shield Association. Have your Member ID card handy. 0000009767 00000 n Last updated on 10/24/2022 10:44:11 AM. 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. 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. 0000020754 00000 n For more information, please refer to Chapter 3, Unit 5 of the Office Manual. Highmark Blue Shield also provides services in conjunction with Blue Cross of Northeastern Pennsylvania in northeastern Pennsylvania and Independence Blue Cross in southeastern Pennsylvania. You also explicitly consent to the automated decision making by us, which may include the processing of your health data, to the extent that it is necessary to process your health claim swiftly and efficiently. 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. 2. 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. This program may not be applicable to all members. or 0000004173 00000 n Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. The member is charged the generic copayment. If you have questions about Medi-Cal Rx , call the Medi-Cal Member Help Line at (800) 541-5555 [TTY: (800) 430-7077], Monday through Friday, 8 a.m. to 5 p.m. Reporting Fraud. 0000009983 00000 n Your ID cards will come from our medical and dental vendors (i.e., Highmark Blue Cross Blue Shield and Cigna). Eligibility, Usage, Activation, Products and Services. Testosterone Product Prior Authorization Form. For those members, the MedcoHealth logo appears on the member's ID card. Highmark's Medical and Pharmacy Affairs department monitors provider-specific formulary prescribing and communicates with providers to encourage use of formulary products. Use this form to determine if a service or item requires prior authorization from the health plan before you receive care. Member Identification Information 3. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. (It is recommended that this prescription be written for a two-week supply.) 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. 0000100729 00000 n We will retain the information in our system in accordance with applicable law and our Data Protection Policy:https://www.highmark.com/hmk2/gdpr.shtml. @ Most prescription drugs are covered when provided or authorized by the PCP on an outpatient basis and obtained at a Premier contracting pharmacy. Highmark Blue Cross Blue Shield of Western New York is a trade name of Highmark Western and Northeastern New York Inc., an independent licensee of the Blue Cross Blue Shield Association. 0000085055 00000 n Highmark Blue Shield serves the 21 counties of central Pennsylvania and also . (ii) when required valid requests by law enforcement. Our vision is to ensure that all members of the community have access to affordable Notes: This consent is given voluntarily and can be revoked at any time in writing by sending an email to PrivacyInternational@HighmarkHealth.org If you want to exert your withdrawal right or your rights to access, rectify, block, transfer or delete your personal data pursuant to the GDPR, please contact us and provide us at least with your full name, address and the data processing you are inquiring about. 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. Rx group number and pharmacy logo -This will be on the ID card whenever a Highmark prescription drug program is included. Accredo will mail your specialty medications to your home or another secure location. 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. For some plans with a mandatory generic provision, if a member requests the brand name drug, but the prescription does not specify "brand medically necessary," the member will be required to pay the difference in cost between the brand drug and the generic drug, in addition to the applicable brand name copayment. For anything else, call 1-800-241-5704. 0000015345 00000 n 0000013585 00000 n If you are on a specialty medication, please contact Accredo, Blue Cross Blue Shields preferred Specialty pharmacy. All FreedomBlue coverage includes at least the same services as those provided by Medicare. 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. Get care for your physical and mental well-being, including prescription drug coveragefrom the doctors, hospitals, and pharmacies you need. Forgot username or password? Non-individual members Sign in to Availity to submit prior authorizations and check codes. The prescription drugs on this list are selected by a team of doctors and pharmacists and are updated on an on-going basis. Once Highmark Blue Shield receives a claim, it will electronically route the claim to the member's Blue Plan. Networks and drug benefits may vary slightly, depending upon the member's group and/or managed care program. Most dosage forms and strengths of a drug are included in the formulary. Highmark is not responsible for lost or stolen cards. Read each plan summary carefully a drug's formulary status may affect how much you pay. Highmark's mission is to be the leading health and wellness company in the communities we serve. Home delivery service is an option that groups may select depending on their benefit design. Your Personal Data will be disclosed to appropriate personnel for purposes of performing services to, or on behalf of, our enterprise customers and prospective customers as part of and in relation to matters regarding our provider, health plan, and subsidiary enterprise care delivery, administration and operations. Managed care members must use one of the participating pharmacies in Highmark's Premier Pharmacy networks. Sunosi Prior Authorization Form. (Members receive a directory of pharmacies with their enrollment materials.) Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. 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. %IVVq+h The sections below provide important . Convenient payment options. (TTY/TDD: 711) Monday through Friday. The member must still pay applicable copayments. (i) when required or permitted by law or government agencies. This committee is comprised of network physicians and pharmacists who select products on the basis of their safety, efficacy, quality and cost to the plan. 0000006499 00000 n 4yxWn8l?W~i1vu+~u^]lY]9\ Os lL&bk2W'ZNQWRM.S A& ISMvbCp-bj'-IW7>}>I7jl Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. 0000008906 00000 n Highmark administers prescription benefits for almost all members. 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. Language Assistance. These services providers are located in the United States. You have access to wellness-related products and services nationwide, so don't forget to take your card with you when traveling. The Highmark Medicare-Approved Prescription Drug Formulary is a list of all covered Part D drugs. 0000053581 00000 n 0000009593 00000 n Use this form when you have paid full price for a prescription drug at a retail pharmacy. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Front of Card Back of Card Highmark Blue Cross Blue Shield Delaware is an independent licensee of the Blue Cross and Blue Shield Association . You must submit claims within 1 year of date of Questions on or after January 1, 2022:. Call 1-877-298-3918. FIND A DOCTOR OR PHARMACY. How Members Use the Home Delivery ServiceMembers can obtain home delivery forms for maintenance drugs by calling the Member Service telephone number on their ID card, or by calling MedcoHealth directly at: 1-800-903-6228. 0000017108 00000 n Licensed Product Name 2. Providers in need of assistance should contact provider services at 800-241-5704 (toll-free). 3. The drug formulary is then divided into major therapeutic categories for easy use. . 0000003041 00000 n 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. Premier Pharmacy NetworksThe prescription drug program offers a wide network of pharmacies and various pharmacy networks, including most national chains and many local, independent pharmacies. 2. Highmark Blue Cross Blue Shield Delaware administers prescription benefits for almost all members. 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. 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. 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). 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. Utilization Management Preauthorization Form: Outpatient Services. Eliminates the need to travel to a pharmacy. Suitcase logo - Indicates a member of the BlueCard program. Security | Privacy | Terms of Use | Notice of Non-Discrimination and Translation Assistance, Notice of Non-Discrimination and Translation Assistance, If this is your first time visiting, youll need to take a moment to register. Providers. You must complete a separate claim form for each pharmacy used and for each patient. The Highmark P&T Committee approves revisions to the drug formulary on a quarterly basis; updates will be provided to reflect such additions. To find a prescription drug on this list, use our Find a Prescription Drug tool. Once a member places an order, the member's information remains on file. 0000010006 00000 n 8:00 a.m. to 5:00 p.m. EST. 0000001704 00000 n Always present your prescription drug ID card at the participating retail pharmacy. This website works best with Internet Explorer 7 and . membership identification card. 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). 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. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. The member can send the other prescription to the home delivery service for up to a 90-day supply. Highmark Health Insurance Company is a PDP plan with a Medicare contract. Pharmacies have point-of-sale technology that confirms a member's eligibility, benefit design and copayment information at the time of dispensing. If you have any questions about home delivery from the Express Scripts Pharmacy or your prescription benefit, please call the number on the back of your member ID card. Applies only to fully insured and community-rated groups. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. 0000011805 00000 n 0000009156 00000 n Do not use this mailing address or form for provider inquiries. %PDF-1.3 % The following outlets do not participate in our wellness debit card program: Pharmacies, sporting goods stores, grocery stores, doctor's offices, optometrists, salons, and department stores. Stand-alone dental and prescription drugs . Over the next few months, we will begin issuing new Highmark ID cards to your patients. General Information about Pharmacy Benefits, http://highmark.medicare-approvedformularies.com. For members with a Highmark Select or Highmark Choice formulary benefit, non-formulary drugs are not covered under a Select formulary benefit or will require a higher co-payment under a Choice formulary benefit. Name of the subscriber - the individual under whose name the coverage 0000018991 00000 n Highmark Health Insurance Company is a PDP plan with a Medicare contract. For those members, the Express Scripts logo appears on the member's ID card. Your Highmark Wellness Rewards Prepaid Mastercard will be mailed directly to you following the processing of your claim. *If you are aMedicaidorChild Health Plusmember, pleaselogin here. 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. Any subsequent refills do not require an order form. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. To view the Highmark Medicare-Approved Select/Choice Formulary for Medicare Advantage or BlueRx members, click here. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. SAMPLE OF A MEMBER ID CARD 1. Need Help? Call Highmark Member Service at the number on the back of your Highmark Member ID card, seven days a week from 8 a.m . Login available after the effective date of your plan. Specialty Drug Request Form. 0000053867 00000 n 4. Members may call the Member Services telephone number on their identification card to find out if they have home delivery coverage. A prescription is required for these drugs and the member must obtain the medication through the pharmacy for coverage to apply. Vyleesi Prior Authorization Form. 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. 4. Notes: This consent is given voluntarily and can be revoked at any time in writing by sending an email to PrivacyInternational@HighmarkHealth.org If you want to exert your withdrawal right or your rights to access, rectify, block, transfer or delete your personal data pursuant to the GDPR, please contact us and provide us at least with your full name, address and the data processing you are inquiring about. 0000004120 00000 n (i) when required or permitted by law or government agencies. Refill requests online, by mail, or by phone anytime, day or night. You also explicitly consent to the automated decision making by us, which may include the processing of your health data, to the extent that it is necessary to process your health claim swiftly and efficiently. We want to clarify these ID card changes for you so you can best . 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. . Transplant Rejection Prophylaxis Medications. Dependent and PCP Information , if applicable 4. 0000006744 00000 n At Highmark Blue Cross Blue Shield of Western New York, we do our best to ensure members have the best wellness options available to get . Please consult your plan documents for details or call customer service. The member can have one of the prescriptions filled at a local pharmacy to begin taking the medication immediately. This service enables members to obtain up to a 90-day supply of either generic or brand name drugs, for either one or two times the retail generic or brand co-payment, or applicable coinsurance, depending upon the member's benefit plan. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Your maintenancemedications are delivered right to your door about 5-7 days after your prescription is received and delivery is free.2, As part of the Affordable Care Act, most members have access to more than 350 preventive medications at a $0 cost-share.3, Pay $10 or less for a 90-day prescription of more than 400 generic medications through Express Scripts home-delivery pharmacy.4. (Some direct pay benefit plans are not available in every region.) Advantages of Using the Mail Order . We will retain the information in our system in accordance with applicable law and our Data Protection Policy:https://www.highmark.com/hmk2/gdpr.shtml. This information will be used for purposes of performing services to, or on behalf of, our enterprise customers and prospective customers as part of and in relation to matters regarding our provider, health plan, and subsidiary enterprise care delivery, administration and operations. 0000017131 00000 n We do so by offering health plans that provide reliable coverage to Western New Yorkers and by supporting the organizations and individuals who work hard every day to keep our communities healthy. And mental well-being, including prescription drug on this list, use our a The plan you choose counties of northeastern Pennsylvania Online, by mail, or by phone anytime day * if you are on a specialty medication, please refer to Chapter 3, Unit 5 the. When provided or authorized by the PCP on an outpatient basis and obtained a! 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highmark bcbs prescription card

highmark bcbs prescription card