Pharmacy Coverage For Employees

Pharmacy Coverage For Employees

Blue KC is committed to providing your employees high-quality, affordable health coverage. What's more, we've found that by offering integrated medical and pharmacy benefits, we can do a better job of managing your employees' health.

Working together with our pharmacy benefit manager, Express Scripts, Inc., we’ve created a high-value pharmacy program that delivers better outcomes and lower costs. And because prescriptions are a vital part of most members’ lives, most every Blue KC plan comes with pharmacy benefits.

Pharmacy Solutions for Business

Retail Pharmacy Network through Express Scripts

  • Large participating network of 68,000+ pharmacies nationwide
  • Tiered network of pharmacies with benefit differential
  • Narrow network of 41,000+ pharmacies

Specialty Pharmacy

Specialty medications are used to treat complex conditions. Often administered through injection or infusion, they can be expensive. To help manage today's growing demand for these specialty medications, we've partnered with Accredo.®

Home Delivery

Your employees can save time and money when they fill their maintenance prescriptions through our mail service pharmacy, Express Scripts. Copayment for most 90-day prescriptions will cost less than the same 90-day prescription from a retail pharmacy.

  • Certain maintenance medications for ongoing conditions like diabetes and high blood pressure;
  • Various medications used regularly like birth control and cholesterol lowering drugs.
  • Express Rx Mobile App lets members manage their medications on the go – order refills, check order status, set up reminders, and more.

Drug Formulary

Drug formulary is the term we use to describe the complete list of prescription medications covered under Blue KC’s pharmacy benefit. We continuously review this formulary for safety, clinical-effectiveness and cost-effectiveness – with input from doctors, pharmacists and other experts.

Here's our current drug formulary. What's more, we offer a generic-based formulary for even greater savings.


Pharmacy Plan FAQs

Have questions about Blue KC pharmacy benefits? Find answers here.


Formulary Management Programs

Blue KC's formulary management programs are designed to be safe and cost-effective. Here's how your employees can receive the most value from their pharmacy benefits.

  • Drug Conversion program for Home Delivery and Retail for certain drugs
  • Prior Authorization ensures that the medication is both necessary and appropriate
  • Step Therapy is a part of our prior authorization program that helps doctors prescribe appropriate and affordable drug treatments. Before coverage is allowed for certain costly "second-step" medications, a less expensive, "first-step" medication is tried.
  • Quantity Limits for certain drugs

How to Apply

Want to offer your employees affordable, high-value pharmacy benefits? Contact your health insurance broker/agent to get started.