January 25, 2022
Blue Cross and Blue Shield of Illinois (BCBSIL) has chosen a new mail order service provider through our pharmacy benefit manager (PBM), Prime Therapeutics LLC (Prime).
As of Oct. 1, 2021, BCBSIL members, whose pharmacy benefits are administrated through Prime, now have Express Scripts® Pharmacy for mail order services. Based on the member’s benefit plan, other in-network pharmacies may be available for 90-day supplies.
This vendor change applies for BCBSIL non-HMO commercial group and retail plan members, as well as Medicaid members who have Blue Cross Community Health PlansSM (BCCHPSM) prescription drug benefits.
Please note: This pharmacy service is an added choice for:
- Medicaid members who have Blue Cross Community MMAI (Medicare-Medicaid Plan)SM prescription drug benefits
- Medicare members
- HMO commercial group and retail plan members
Your patients may ask you to move their prescription(s) to the new pharmacy service.
Mail order service provides a convenient way for your patients to get up to a 90-day supply of a maintenance (or long-term) medicine by mail.
- When renewing your patients’ current maintenance prescriptions or when writing new prescriptions for mail order, ask your patients for their preferred mail order service.
- If your patients want to use Express Scripts® Pharmacy, you can send the prescriptions:
- Electronically – Use your electronic medical record (EMR) system to e-prescribe to: Express Scripts Home Delivery. For questions on e-prescribing, call 800-211-1456, option 5.
- By Fax – Call 888-327-9791 for faxing instructions. (Faxes can only be received from a doctor’s office.)
- By Phone – Call the pharmacy at 833-715-0942 (for commercial group and retail plan members), 833-599-0731 (for BCCHP members), 833-599-0729 (for Medicare Part D plan and MMAI members) or 833-715-0944 (for Medicare Advantage plan members).
- About Express Scripts® Pharmacy:
- With a thorough validation process, the pharmacy has a 99.99% dispensing accuracy and more than 30 years of prescription home delivery experience.
- Pharmacists leverage their clinical knowledge and experiences to review for possible drug therapy issues and address adherence gaps.
- There are many locations across the U.S., allowing for fast processing and dispensing with no added cost for standard delivery.
- Support staff are on hand 24 hours a day, 7 days a week to help with any medicine questions or concerns.
- Members can use digital tools to refill prescriptions, track orders, set reminders to take medicine(s) and more.
- For more information on Express Scripts® Pharmacy, visit their website
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Please take this opportunity to update any pharmacy information that may be stored in your patients’ records. Also, if your patient had a current prior authorization approval on file, it will follow the standard BCBSIL process for renewals.
Members can call us at the number listed on their BCBSIL member ID card if they have any questions. If you have any questions, need further help or need to check a patient’s coverage, call us at the number on your patient’s ID card.
Express Scripts® Pharmacy is a pharmacy that is contracted to provide mail pharmacy services to members of Blue Cross and Blue Shield of Illinois (BCBSIL). The relationship between Express Scripts® Pharmacy and BCBSIL is that of independent contractors. Express Scripts® Pharmacy is a trademark of Express Scripts Strategic Development, Inc.
Prime Therapeutics LLC is a separate pharmacy benefit management company contracted by BCBSIL to provide pharmacy benefit management and related other services. BCBSIL, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics.
Pharmacy benefits and limits are subject to the terms set forth in the member’s certificate of coverage which may vary from the limits set forth above. For more complete details, including benefits, limitations and exclusions, members should refer to their certificate of coverage. Regardless of benefits, the final decision about any medication and pharmacy choice is between the member and their health care provider.