Highmark Blue Cross Blue Shield of Western New York is a trade name of Highmark Western and Northeastern New York Inc., an independent licensee of the Blue Cross Blue Shield Association. How Members Use the Home Delivery ServiceMembers can obtain home delivery forms for maintenance drugs by calling the Member Service telephone number on their ID card, or by calling MedcoHealth directly at: 1-800-903-6228. or Utilization Management Preauthorization Form: Outpatient Services. Accredo will mail your specialty medications to your home or another secure location. After that, all Personal Data will be deleted or the documents with such data will be anonymized. . This information will be used for purposes of performing services to, or on behalf of, our enterprise customers and prospective customers as part of and in relation to matters regarding our provider, health plan, and subsidiary enterprise care delivery, administration and operations. Any subsequent refills do not require an order form. Enrollment in Highmark Choice Company, Highmark Senior Health Company, Highmark Senior Solutions Company, Highmark BCBSD Inc., Highmark Western New York and Northeastern New York Inc. and Highmark Health Insurance Company depends on contract renewal. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. 2. All FreedomBlue coverage includes at least the same services as those provided by Medicare. Questions on or after January 1, 2022:. Not subject to a deductible. Use this form to determine if a service or item requires prior authorization from the health plan before you receive care. Members may call the Member Services telephone number on their identification card to find out if they have home delivery coverage. We will retain the information in our system in accordance with applicable law and our Data Protection Policy:https://www.highmark.com/hmk2/gdpr.shtml. Front of Card Back of Card Highmark Blue Cross Blue Shield Delaware is an independent licensee of the Blue Cross and Blue Shield Association . A prescription is required for these drugs and the member must obtain the medication through the pharmacy for coverage to apply. All references to Highmark in this document are references to the Highmark company that is providing the members health benefits or health benefit administration. The drug formulary is divided into sections based on the member's plan benefit design. To view the Highmark Select/Choice Formulary, click here. Highmark Blue Cross Blue Shield Delaware administers prescription benefits for almost all members. 0000017131 00000 n Premier Pharmacy NetworksThe prescription drug program offers a wide network of pharmacies and various pharmacy networks, including most national chains and many local, independent pharmacies. (TTY/TDD: 711) Monday through Friday. 0000009983 00000 n The member is charged the generic copayment. Login available after the effective date of your plan. This website works best with Internet Explorer 7 and above or Firefox 2.0 and above. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Drugs are listed by brand and generic names. With Highmark Blue Cross Blue Shield of Western New York, getting and staying healthy is now more affordable with our nationwide wellness debit card benefit. Licensed Product Name 2. The Highmark Drug Formulary is a list of FDA-approved prescription drug medications reviewed by our Pharmacy and Therapeutics (P&T) Committee. If you have questions about Medi-Cal Rx , call the Medi-Cal Member Help Line at (800) 541-5555 [TTY: (800) 430-7077], Monday through Friday, 8 a.m. to 5 p.m. Highmark's mission is to be the leading health and wellness company in the communities we serve. 0000006046 00000 n Call 1-800-996-9969 or visit Delaware ASSIST to enroll. 0000001704 00000 n You can contact them for any questions you may have regarding your condition, the specialty medication, and/or any side effects you may be experiencing. 0000015345 00000 n Mandatory Generic FeatureMany plans include a mandatory generic provision, which requires that if the generic drug exists but the member or physician specifically requests the brand name drug, the member will have to pay the brand name copayment and the cost difference between the brand name drug and the generic drug. Call 1-877-298-3918. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Forgot Password, Whether you fill your prescriptions at a local pharmacy or have them delivered, our tool helps you select the lowest-cost pharmacy, identify lower-cost alternatives, and compare brand-name and generic costs.1, You can save both time and money with mail-order prescriptions through the Express Scripts home-delivery program. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also . This website works best with Internet Explorer 7 and . 1. Name of the subscriber - the individual under whose name the coverage You also explicitly consent to the automated decision making by us, which may include the processing of your health data, to the extent that it is necessary to process your health claim swiftly and efficiently. 0000004173 00000 n Need Help? 0000013562 00000 n Notes: This consent is given voluntarily and can be revoked at any time in writing by sending an email to PrivacyInternational@HighmarkHealth.org If you want to exert your withdrawal right or your rights to access, rectify, block, transfer or delete your personal data pursuant to the GDPR, please contact us and provide us at least with your full name, address and the data processing you are inquiring about. Read each plan summary carefully a drug's formulary status may affect how much you pay. Fax to (716) 887-7913 . For refills, the member can call the toll-free number, send in the refill form with the applicable co-payment, or visit Highmark's web site at www.highmarkblueshield.com. (iii) for purposes relevant to corporate policies or litigation to the extent permitted under applicable law or when it is prescribed in GDPR or other applicable law. Pharmacies have point-of-sale technology that confirms a member's eligibility, benefit design and copayment information at the time of dispensing. For anything else, call 1-800-241-5704. 0000082377 00000 n Call Highmark Member Service at the number on the back of your Highmark Member ID card, seven days a week from 8 a.m . Eliminates the need to travel to a pharmacy. Highmark Health Insurance Company is a PDP plan with a Medicare contract. Always present your prescription drug ID card at the participating retail pharmacy. Home page. Last updated on 10/24/2022 10:44:11 AM. 0000100729 00000 n This information will be used for purposes of performing services to, or on behalf of, our enterprise customers and prospective customers as part of and in relation to matters regarding our provider, health plan, and subsidiary enterprise care delivery, administration and operations. This service enables members to obtain up to a 90-day supply of either generic or brand name drugs, for either one or two times the retail generic or brand co-payment, or applicable coinsurance, depending upon the member's benefit plan. Pharmacy Benefits for FreedomBlue MembersCopayments and coverage limitations vary depending on the region, group, and/or direct-pay enrollment. Download the latest version to access the site. The main identifiers for BlueCard members are the alpha prefix, a blank suitcase logo, and, for eligible PPO members, the "PPO in a suitcase" logo. 0000053660 00000 n Your Personal Data will be disclosed to appropriate personnel for purposes of performing services to, or on behalf of, our enterprise customers and prospective customers as part of and in relation to matters regarding our provider, health plan, and subsidiary enterprise care delivery, administration and operations. Reporting Fraud. Have your member ID card handy, Up to a 90-day supply of each covered medication (compare to a typical retail 30-day supply), Pharmacists available 24/7 to answer your questions, Eliminates the need to travel to a pharmacy, Refill requests online, by mail, or by phone anytime, day or night, Some plans may have an expanded preventive drug list. If you have questions regarding how we process your Personal Data and what we store about you, please contact PrivacyInternational@HighmarkHealth.org or write us: By agreeing to the terms and conditions set out in this Data Protection Statement, and by providing us with your Personal Data, you consent to the collection, use and disclosure of any information you provide in accordance with the above purposes and this Data Protection Statement. If you are not satisfied with our data processing you have the right to lodge a complaint to the data protection authority in your country of residence. Transplant Rejection Prophylaxis Medications. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. To find a prescription drug on this list, use our Find a Prescription Drug tool. Additionally, Accredo has specialized pharmacists who know and understand your conditions. General Information about Pharmacy Benefits, http://highmark.medicare-approvedformularies.com. 8:00 a.m. to 5:00 p.m. EST. Home delivery service is an option that groups may select depending on their benefit design. Our vision is to ensure that all members of the community have access to affordable You must complete a separate claim form for each pharmacy used and for each patient. We do so by offering health plans that provide reliable coverage to Western New Yorkers and by supporting the organizations and individuals who work hard every day to keep our communities healthy. At Highmark Blue Cross Blue Shield of Western New York, we've built our legacy around empowering our communities and helping you be your very best you. |wx[en%L!Z300a`NNh0 )\ endstream endobj 475 0 obj 168 endobj 436 0 obj << /Type /Page /Parent 432 0 R /Resources << /ColorSpace << /CS2 437 0 R /CS3 442 0 R >> /ExtGState << /GS2 468 0 R /GS3 469 0 R >> /Font << /TT4 440 0 R /TT5 438 0 R /TT6 445 0 R /T1_1 453 0 R /TT7 452 0 R >> /ProcSet [ /PDF /Text ] >> /Contents [ 444 0 R 448 0 R 456 0 R 458 0 R 460 0 R 462 0 R 464 0 R 466 0 R ] /MediaBox [ 0 0 612 792 ] /CropBox [ 0 0 612 792 ] /Rotate 0 /StructParents 0 >> endobj 437 0 obj [ /ICCBased 471 0 R ] endobj 438 0 obj << /Type /Font /Subtype /TrueType /FirstChar 32 /LastChar 148 /Widths [ 250 0 0 0 0 0 0 180 333 333 0 564 250 333 250 278 500 500 500 500 500 500 500 500 500 500 278 278 0 0 0 0 0 722 667 667 722 611 556 722 722 333 0 0 611 889 722 722 556 722 667 556 611 722 722 944 722 722 611 0 0 0 0 0 0 444 500 444 500 444 333 500 500 278 278 500 278 778 500 500 500 500 333 389 278 500 500 722 500 500 444 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333 444 444 ] /Encoding /WinAnsiEncoding /BaseFont /EADBCI+TimesNewRoman /FontDescriptor 439 0 R >> endobj 439 0 obj << /Type /FontDescriptor /Ascent 891 /CapHeight 656 /Descent -216 /Flags 34 /FontBBox [ -568 -307 2028 1007 ] /FontName /EADBCI+TimesNewRoman /ItalicAngle 0 /StemV 94 /XHeight 0 /FontFile2 467 0 R >> endobj 440 0 obj << /Type /Font /Subtype /TrueType /FirstChar 32 /LastChar 174 /Widths [ 250 0 0 0 0 0 0 0 333 333 0 0 250 333 250 278 500 500 500 500 500 500 500 500 500 500 0 0 0 0 0 500 0 722 667 722 722 667 611 0 778 389 0 0 667 944 0 778 611 778 0 556 667 722 0 1000 0 0 0 0 0 0 0 0 0 500 556 444 556 444 333 500 556 278 0 556 278 833 556 500 556 556 444 389 333 556 500 722 500 500 444 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 333 500 500 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 747 ] /Encoding /WinAnsiEncoding /BaseFont /EADBEJ+TimesNewRoman,Bold /FontDescriptor 441 0 R >> endobj 441 0 obj << /Type /FontDescriptor /Ascent 891 /CapHeight 656 /Descent -216 /Flags 34 /FontBBox [ -558 -307 2034 1026 ] /FontName /EADBEJ+TimesNewRoman,Bold /ItalicAngle 0 /StemV 160 /XHeight 0 /FontFile2 470 0 R >> endobj 442 0 obj /DeviceGray endobj 443 0 obj 1793 endobj 444 0 obj << /Filter /FlateDecode /Length 443 0 R >> stream Highmark is not responsible for lost or stolen cards. Get care for your physical and mental well-being, including prescription drug coveragefrom the doctors, hospitals, and pharmacies you need. Over the next few months, we will begin issuing new Highmark ID cards to your patients. Forgot Username Use this form when you have paid full price for a prescription drug at a retail pharmacy. Eligibility, Usage, Activation, Products and Services. All reasonably appropriate measures will be taken to prevent disclosure of your Personal Data beyond the scope provided directly or indirectly herein or as may be reasonably inferred from the content contained in this notice or the website. 0000001211 00000 n 0000002426 00000 n Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Applies only to fully insured and community-rated groups. Enrollment in Highmark Choice Company, Highmark Senior Health Company, Highmark Senior Solutions Company, Highmark BCBSD Inc., Highmark Western New York and Northeastern New York Inc. and Highmark Health Insurance Company depends on contract renewal. Providers. 0000008651 00000 n If you have any questions about home delivery from the Express Scripts Pharmacy or your prescription benefit, please call the number on the back of your member ID card. Products that are approved for more than one therapeutic indication may be included in more than one category. For those members, the MedcoHealth logo appears on the member's ID card. Please review your benefit summary documents or contact customer service, Nearly 80% of prescriptions filled in the U.S. are generics, They work just like brand-name medications and have the same active ingredients, Many generics are manufactured by the same company that makes the brand-name medications, Generics are of the same quality, strength, and purity standards as non-generic. membership identification card. We want to clarify these ID card changes for you so you can best . Pay Premium. You now have one card for both your medical and prescription benefits.

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