Maintenance Medication Benefits
We offer several benefit options to help commercial members with our pharmacy benefits save money on these medications they take regularly (maintenance medications), with a focus on promoting mail service.
Maintenance Medication List
| Benefit |
Which members may have the benefit |
Coverage |
|
Mail Order with Retail Choice
Member fact sheet
|
Fully insured commercial members
- Standard benefit for employers with up to 50 employees
- Opt-in for employers with 51 or more members
|
- Member can fill their first two maintenance medication prescriptions at a retail pharmacy
- By their third fill, the member must either switch to the mail service pharmacy or formally opt out to stay at a retail pharmacy
- If the member does nothing and stays at a retail pharmacy, they’ll pay 100% of their medication's cost
|
|
Maintenance Choice Voluntary
Member fact sheet
|
Self-insured commercial members
|
- Member can fill a 30-day supply at any retail pharmacy
- For 90-day supplies, the member can choose any pharmacy in the program (members can sign in to their MyBlue account to find an eligible pharmacy)
- Use of a specific pharmacy is not required for coverage
|
|
Maintenance Choice Exclusive
Member fact sheet
|
Self-insured commercial members
- Employers who choose this benefit
|
- Requires the member to fill a 90-day prescription for their maintenance medication
- Member can receive their first two fills at any retail pharmacy
- By their third fill, members must transition to any pharmacy in the program (members can sign in to MyBlue to find an eligible pharmacy)
- If the member uses any other pharmacy, they will pay 100% of their medication’s cost
|
