Questions and answers

Does Highmark cover prescriptions?

Does Highmark cover prescriptions?

In most cases, your prescriptions are covered under your Highmark plan only if they are filled at a network pharmacy or through our mail-order pharmacy service. A network pharmacy is a pharmacy that has agreed to provide prescription drug benefits at negotiated prices for Highmark members.

What specialty pharmacy does Highmark use?

If approved, Highmark will forward to Walgreens Specialty Pharmacy, LLC., our specialty vendor. Walgreens Specialty Pharmacy can be reached at 888-347-3416.

How do I know what pharmacy takes my insurance?

Call your insurance company or visit their website to find out whether your regular pharmacy is in-network under your new plan and, if not, what pharmacies in your area are in-network. You can also learn if you can get your prescription delivered in the mail.

Does Highmark have a mail order prescription drug plan?

Welcome! We’re proud that Highmark has chosen Express Scripts to help administer your prescription drug benefit for mail-order services. You’re now with the industry leader. Express Scripts has provided quality prescription drug benefit services to millions of Americans for over 30 years.

Which chain pharmacies participate in Highmark’s Medicare Preferred Value Pharmacy Network for 2020?

Local pharmacies that remain in the preferred network in 2020 include all locations of CVS, Giant Eagle, Rite Aid, Sam’s Club, Tops Market and Walmart. David Bruce can be reached at 870-1736 or by email.

Which chain pharmacies participate in Highmark’s Medicare Preferred Value pharmacy Network for 2020?

Can I use Anthem Insurance at Walgreens?

Walgreens and Walgreen owned stores such as Duane Reade and Happy Harry’s have now partnered with Anthem Blue Cross Blue Shield and starting September 15th will participate as an in-network pharmacy. All Anthem BCBS plans have some type of drug coverage, but plan benefits can vary greatly.

What if a drug is not on formulary?

If you and your doctor believe that you need a medication that isn’t on your health plan’s formulary, you can submit a formulary exception request, asking your insurer to cover the drug and documenting the reasons that other covered options won’t work.

Do all pharmacies accept all insurance?

Pharmacy Services Acceptance of insurance plans varies by Pharmaca location; all locations do not necessarily accept all plans listed and in most cases will accept additional plans.

Can I pay cash for a prescription if I have insurance?

1) My insurance won’t cover my prescription Just ask the pharmacist if you can pay cash for it so there’s no delay. If it’s a new prescription that will be ongoing (for example, overactive bladder medication, high blood pressure meds, or diabetes meds) contact your doctor right away to get the prior authorization.

What is a Medicare Part D prescription drug plan formulary?

A formulary is the list of drugs covered by a Part D plan. Medicare requires all Part D plans to cover at least two drugs in each therapeutic drug category. Some types of drugs are not covered by Medicare Part D, such as drugs for weight loss or cosmetic purposes.

Can my drug formulary change?

A formulary may change when a new more cost-effective prescription drug comes to market or when new safety information about a prescription drug is released. Sometimes a plan will let you continue to fill prescriptions for a prescription drug removed from the formulary throughout the period of the coverage year if you are already taking it.

What is the drug formulary?

A drug formulary is a list of prescription drugs, both generic and brand name, used by practitioners to identify drugs that offer the greatest overall value. A committee of independent, actively practicing physicians and pharmacists maintain the formulary. The formulary can change from time to time.

What does the term formulary pharmacy mean?

At its most basic level, a formulary is a list of medicines. Traditionally, a formulary contained a collection of formulas for the compounding and testing of medication (a resource closer to what would be referred to as a pharmacopoeia today).