Your Highmark Blue Shield Mail-Order Pharmacy Brochure

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1 Your Highmark Blue Shield Mail-Order Pharmacy Brochure

2 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. What s inside: Medications preferred by your plan The Medco Pharmacy mail-order service Online services General information Other things you should know

3 Medications preferred by your plan Your prescription drug benefit may include a list of prescription drugs that are preferred by your plan because they help to control rising prescription drug costs. This list, called a formulary, has a wide selection of generic and brand-name medications. If you need information about your plan s preferred medications, visit us at or call us toll-free at The Medco Pharmacy mail-order service (Now a part of the Express Scripts family of pharmacies.) Over 6 million members enjoy the convenience and savings of having their long-term medications (those taken for 3 months or more) delivered to their home or office. Medications are dispensed by Express Scripts pharmacists through our network of mail-order pharmacies. Medco Pharmacy advantages: Get up to a 90-day supply of each covered medication for just one mail-order copayment. Registered pharmacists are available 24 hours a day, 7 days a week. Order refills online, by mail, or by phone anytime day or night. Refills are usually delivered within 3 to 5 days after we receive your order. To order online, register for the Medco Pharmacy by visiting Log in as a member. Click on the Your Prescriptions link under Your Health. Click on Fill Mail Order Rx to proceed. Choose a convenient payment option Express Scripts offers two safe, convenient automatic payment options for prescription orders. You can use e-check to have payments automatically deducted from your checking account. Or you can use AutoCharge to have payments automatically billed to the credit/debit card of your choice. You can also pay for individual orders by money order, personal check, or credit/debit card. For more information, call Member Service. Standard shipping is free. 3

4 How to start saving with the Medco Pharmacy 1 When using the Medco Pharmacy, be sure to ask your doctor to write a prescription for up to a 90-day supply of each medication (plus refills for up to 1 year, if appropriate). 2 Fill out the enclosed Medco Pharmacy order form. 3 Send the completed form, your prescription, and your payment in the envelope provided. Your medication usually will be delivered within 8 days after we receive your new order. If you are currently taking a medication, be sure to have at least a 14-day supply on hand when ordering. If you don't have enough, ask your doctor to give you a second prescription for a 14-day supply and fill it at a participating retail pharmacy while your mail-order prescription is being processed. You may also have your doctor fax your prescriptions. Ask your doctor to call for faxing instructions. 4

5 Online services If you have Internet access, just go to and: Log in as a member. Click on "Your Prescriptions" link under Your Health. Then follow the instructions to proceed. Important features: Compare the cost of brand-name and generic drugs via mail order. Search for lower cost medication alternatives and equivalents. Access health and wellness information. Obtain order forms and envelopes. Submit mail-order refills. Check the status of Medco Pharmacy orders. First-time user registration If you have not yet registered to use the Highmark member Web site, here s how to get started: Go to the Highmark member Web site: Click on the Members tab at the top of the page or the Log In link at the bottom of the page. Click on the Register Now link in the Log In box on the right side of the page. Key in the information requested. Refer to your Highmark member ID card and enter numbers only. Create your password for security reasons, it must be six characters with a combination of letters and numbers. You ll receive a message regarding your Personal Identification Number (PIN). A PIN is required to access your personal, protected health information. You ll receive your PIN via U.S. Mail within 3 to 5 business days. In the meantime, you can access other features on the site that are not personal. The next time you log onto the Web site, enter your PIN when prompted. This is the only time you need to enter your PIN. 5

6 General information For Express Scripts Member Service inquiries Member Service is available 24 hours a day, 7 days a week (except Thanksgiving and Christmas) by calling toll-free Our Member Service representatives can: Help you find a participating retail pharmacy Send you order forms, claim forms, and envelopes Answer questions about your prescriptions or your prescription drug benefit To access Express Scripts by TTY TTY is available for hearing/speech impaired members Call To order prescription labels printed in Braille Braille labels are available for mail-order prescriptions. Call

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8 Other things you should know Express Scripts protects your safety The risks associated with drug-to-drug interactions and drug allergies can be very serious. To protect your safety whether you use the Medco Pharmacy or highmarkblueshield.com Express Scripts checks for potential interactions and allergies. We also send information electronically to participating retail pharmacies. Express Scripts may contact your doctor about your prescription If you are prescribed a drug that is not on your plan s preferred list, we may contact your doctor to ask whether a drug on the preferred list would be appropriate for you. Express Scripts protects your privacy Because your privacy is important to us, Express Scripts complies with federal privacy regulations. Express Scripts only uses health and prescription information about you and your dependents to administer your plan and to fill your mail-order prescriptions. Your plan may have coverage limits Your plan may have certain coverage limits. For example, prescription drugs used for cosmetic purposes may not be covered, or a medication might be limited to a certain amount (such as the number of pills or total dosage) within a specific time period. If you submit a prescription for a drug that has coverage limits, Express Scripts will advise you, in writing, that approval is needed before the prescription can be filled. If this occurs, you will be provided with a special toll-free number for your doctor to contact. This will initiate the review process for your medication. Once the review is complete, you and your doctor will be notified of the decision. You may have the opportunity to appeal this decision, based on the parameters of your benefit design. Highmark Blue Shield is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. Highmark is a registered mark of Highmark Inc. Express Scripts is an independent company that administers pharmacy services Express Scripts Holding Company. All rights reserved. * BH8275B* * BH8275B*