Blue Option provides members with a wide array of plans with multiple pharmacy options. The good news is that Blue Option members will
NOT have a separate pharmacy deductible for 2016. We are building members’ pharmacy charges into the deductible or applying them to the maximum out-of-pocket expenses, depending on the plan selection.
Tier Change
As a reminder, Blue Option members will have six-tier copayment/coinsurance levels for their prescription drugs effective January 1, 2016. This new approach provides more flexibility in managing high-cost and specialty medications regardless of whether a drug is generic or a brand. We have taken great steps to ensure members have all classes of drugs covered and spread across six tiers for better affordability for our members. You and your customers should review our
online Covered Drug List to see on which tier a specific drug is located.
Double Check Your Copayments by Tier to Ensure the Best Value
When you are advising members, please be sure to compare the copayment amounts for Blue Option tiers carefully to determine the best value. For example, if you are looking at a specific drug, please compare that drug copayment and cost to the Blue Option Tiers 1
and 2. Remember, Tiers 1 and 2 contain generic drugs which could mean lower costs to your members’ out-of-pocket expenses. Therefore, Blue Option value may be greater to the member and less expensive overall.
This chart compares the Blue Option pharmacy benefit from last year to the new six-tier option for 2016. Drugs on the lowest tiers will cost members the least amount of money.
Again, we highly encourage you to review the
2016 Covered Drug List to ensure a seamless transition for your customers.
Make Blue Option Your Only Option!
For more information about comprehensive Blue Option pharmacy benefits, please contact your BlueChoice HealthPlan representative.
