The University of Alabama uses Prime Therapeutics as our pharmacy benefit management company, the partner of choice for Blue Cross and Blue Shield of Alabama. Carved-in medical and pharmacy benefits provides our employees with improved customer service, including:
- One ID card for both medical and pharmacy benefits;
- One source for all mailed communications;
- One number to call for 24/7/365 access to Member Services;
- Single sign-on at myBlueCross website for access to medical & pharmacy claims, drug cost comparison tools, and formulary information.
- Seamless integration between medical and pharmacy claims which is critical because the new High Deductible Health Plan requires real-time accumulation of claims data for both deductibles and out-of-pocket maximums.
What prescription drugs are covered?
Formulary Information: The HDHP and PPO medical plans use the same formulary, the NetResults 1.0 Drug List – 4 Tiers (Standard) for Large Group Plans. You can view all prescription drug lists on the Blue Cross and Blue Shield website. Prime updates the formulary once per quarter.
- Maintenance Drugs are prescriptions commonly used to treat conditions that are considered chronic or long-term. These conditions usually require regular, daily use of medicines. Examples of maintenance drugs are those used to treat high blood pressure, heart disease, asthma and diabetes. View the Maintenance Drug List under Drug List for ALL Large Group Plans.
- Specialty Drugs are generally prescribed for people with complex or on-going medical conditions such as multiple sclerosis, hemophilia, hepatitis C and rheumatoid arthritis. These high cost medications also have one or more of the following characteristics: injected or infused, but some may be taken by mouth; unique storage or shipment requirements; additional education and support required from a health care professional; and usually not stocked at retail pharmacies. View the Specialty Pharmacy Drug List under Drug List for ALL Large Group Plans.
Is my pharmacy in-network?
Network Information: To locate an in-network pharmacy, use the Find a Doctor tool provided by Blue Cross and Blue Shield of Alabama.
What are my prescription drug copays?
PPO Medical Plan Copayments: The PPO Medical Plan Matrix includes a list of retail and home delivery copays for Tier 1, Tier 2, Tier 3 and Tier 4 drugs.
Additional Resources
- Formulary: NetResults 1.0 Drug List – 4 Tiers (Standard)
- Pharmacy Frequently Asked Questions
- Drug Coverage Guidelines
- HealthSmartRx Smart RxAssist for Provider-Administered Drugs
Home Delivery Prescription Drug Service
Mail order/home delivery is a convenient and cost-effective way for you to order up to a 90-day supply of maintenance or long-term medication for delivery to your home. Home Delivery service is available to employees enrolled in UA’s medical plan. You may be taking medication for an extended period of time, but not all medications are considered maintenance medications by the plan. Please call Prime Therapeutics at 1-800-216-9920 to determine if your medication is classified as a maintenance drug.
Contact Customer Service: Questions concerning home delivery benefits or eligibility, how to order prescriptions or check the status of an order, should be directed to Prime Therapeutics. You may also order refills and check the status of an order online at www.bcbsal.org/web/home-delivery-network.
Home Delivery Timeline: Your prescription will be delivered to you, free of charge, by U.S. Mail or other carrier, within approximately 10 days from receipt of the order. Rush shipping is available for an additional charge. If you wish to obtain a brand name drug when a generic is available, your doctor must write “dispense as written” or “brand necessary” on the prescription. Otherwise, generic will be dispensed when appropriate and permitted by your physician.
How do I enroll in home delivery services?
- Enroll in home delivery online at https://www.bcbsal.org/web/home-delivery-network. You’ll need to provide your address and payment details as well as health and allergy information.
- Have your doctor write your prescription for the number of days allowed for your medication (up to 90 days). For written prescriptions, always fill out an order form. Alternatively, your doctor may call, fax, or electronically prescribe your medications for home delivery. Contact Customer Service for details.
- Mail your order form(s), original written prescription(s) and payment (check or credit card information) to the address listed for the appropriate Home Delivery Network.
How do I order prescription refills?
You can order refills by using one of the following methods at least two weeks before your current supply runs out. Be prepared to provide the patient’s date of birth, member ID number, prescription number(s) and credit card information.
- Online – Log into https://www.bcbsal.org/web/home-delivery-network Choose “Home Delivery” on “My Prescription Dashboard” and select “Refill Prescriptions”.
- By mail – Send in the refill slip that came with your previous order. Be sure to include your copay.
- Automatic Refills – Some prescriptions are eligible for automatic refills. Ask Prime Therapeutics customer service for details.
No refills left on the Home Delivery Prescription: If your prescription label indicates “0” refills or your refill request states “your prescription has expired,” please do the following: 1) request a new prescription from your doctor, and 2) mail your order form, the original (not duplicate) written prescription(s) and payment (check or credit card information) to the appropriate address listed online.