BlueValueSM RX Formulary
BlueValue Rx is a pharmacy program that combines the traditional three-tier pharmacy benefit with the Blue Cross Blue Shield of Massachusetts high-performance formulary. This Blue Cross Blue Shield of Massachusetts formulary is designed to provide coverage for a wide variety of generic medications and low-cost brand-name medications that are safe, affordable, and clinically effective. In addition to your copayment, your prescription benefits may also include co-insurance, deductibles, and maximums.
Questions About Covered Medications Before You Enroll
If you haven't yet enrolled in a Blue Cross Blue Shield of Massachusetts health plan that offers BlueValue Rx, and would like to learn whether your medication is covered, please contact your benefits administrator. He or she can help you learn more about a special website for those considering enrolling in a health plan that offers BlueValue Rx.
Questions About Our Covered Medications After You Enroll
If you recently enrolled in a Blue Cross Blue Shield of Massachusetts health plan that offers BlueValue Rx, and would like to learn whether your medication is covered by our formulary, you can go online and search our covered medications list. Here's how:
- Register at www.express-scripts.com, our pharmacy benefit partner.
- Once registered, you'll have access to the BlueValue Rx formulary.
- To learn whether your medication is covered, use the Price Check feature in the Tools section.
- Choose your medications, or the medications of a covered family member by typing in the first four letters of the name.
- If your medication is covered, it will appear at the top of the page.
- If your medication is not covered, please talk with your doctor to find an alternative covered medication. Your doctor may request coverage from our Clinical Pharmacy Department for a non-covered medication if no covered alternative is appropriate for treating your condition.
You can also use the Price Check feature to learn how much you'd pay for your medication at a retail pharmacy versus the mail service feature offered by Express Scripts, Inc.
About Your ID Card and Your Copayments
Copayment amounts are printed on the front of your ID card. BlueValue Rx has three tiers of copayment amounts that you pay depending upon your medication.
When you fill a prescription, the amount you pay the pharmacy (your prescription copayment) is determined by the tier your medication is on. Medications are listed on tiers according to a variety of factors, including what they are used for, their cost, and whether equivalent or alternative medications are available. The pharmacy will advise you of the amount you owe.
For more about your specific prescription benefits, call the Member Service number listed on the front of your ID card.