Optimize Your New Pharmacy Benefits

Retail Pharmacy Network

Fill your prescriptions at thousands of retail pharmacies and many national drug stores, supermarkets and large retailers.

Home Delivery

To save time and money, you can choose to have your maintenance medications delivered directly to your home. To learn more, visit our Home Delivery FAQ page.

Specialty Pharmacy

Our specialty pharmacy can help you manage your chronic conditions and specialty therapies. To learn more, visit our Specialty Pharmacy FAQ page.

If you use Express Scripts for home delivery or Accredo for specialty pharmacy services, you'll be receiving transition information in the mail before the end of the year.

Find a Network Pharmacy

You'll be able to fill your prescriptions at thousands of retail pharmacies and many national drug stores, supermarkets and large retailers. Blue KC will always make it easy to access the pharmacy services you need.

New Network Names for 2020

Current Pharmacy Network Names

Search your 2020 Pharmacy Network

Know What Medications are Covered

The Prescription Drug List – also known as a formulary – is a list of prescription medications that have been reviewed and recommended by Blue KC's Medical and Pharmacy Management Committee. The list includes both brand-name and generic prescription medications approved by the Food and Drug Administration (FDA).

Download the

Prescription Drug List

The Prescription Drug List will not change beyond the traditional updates that occur routinely twice a year.
Blue KC will always alert you to any changes.

Know Your Medication Costs

To help you plan for future pharmacy costs, Blue KC has compiled estimated pricing for the top 500 most commonly prescribed medications.

Download your new

Pricing Estimates

Medication prices, individual retail pricing and individual copayments may vary. Pharmacist's judgment, your doctor's instructions on how to take the medication, and applicable law may impact the actual dispensed quantity and/or days' supply you may receive. Medication costs outside of your prescription program, and sales tax, where applicable, are not included.

The coverage and pricing terms of the prescription benefit are subject to change.

Frequently Asked Questions

  • Yes, up to two years of your prescription claims history will be available. On or after January 1, 2020, log into MyBlueKC.com, click Plan Benefits then Pharmacy Plan Info and then View Your Pharmacy Benefits.

  • If you have questions about this information, or your pharmacy coverage in general, please call Blue KC Customer Service at the number listed on your member ID card, Monday through Friday, from 8 a.m. to 8 p.m. Central Time.

  • Our home delivery program is a convenient, cost-effective and safe option for getting medications you take regularly.

    • Medications are delivered directly to your door, which means fewer trips to the pharmacy
    • You receive up to a 102-day supply, which may save you money on copays
    • Pharmacists are available by phone 24 hours a day, 7 days a week to answer questions
    • You can set up automatic text reminders to help you remember when to take your medication and refill your prescriptions
    • You can enroll in a program which automatically refills and delivers your eligible maintenance medications to you
  • Beginning January 1, 2020, Blue KC is partnering with OptumRx to provide all your pharmacy benefits, including our new home delivery program.

    Anyone who previously used Express Scripts for home delivery of prescription medications will receive a letter with detailed transition instructions.

    In January 2020, you’ll also receive a letter with information about what prescriptions have transferred over to the new home delivery program. Follow-up phone calls will then be made to help address any additional questions.

    To help prepare for the transition, we recommend that you speak with your doctor and ensure you have enough medication on hand to last you until February 1, 2020. Most home delivery prescriptions with remaining refills will automatically transfer. However, prescriptions for certain medications will not. Examples include controlled substances and prescriptions that have expired. In these cases, you’ll need a new prescription from your doctor.

    On or after January 1, 2020, you can easily set up your home delivery by calling 1-844-579-7774 or by logging into MyBlueKC.com, clicking Plan Benefits then Pharmacy Plan Info and then View Your Pharmacy Benefits. You’ll need to provide shipping and payment preferences before you can receive your first shipment through our new home delivery program.

  • On or after January 1, 2020, you can track your home delivery order status online by logging into MyBlueKC.com, clicking Plan Benefits then Pharmacy Plan Info and then View Your Pharmacy Benefits.

  • On or after January 1, 2020 there are three ways to register with our new home delivery program:

    • Your doctor can send in an electronic prescription.
    • You can log into MyBlueKC.com, click Plan Benefits then Pharmacy Plan Info and then View Your Pharmacy Benefits.
    • You can call 1-844-579-7774
  • To keep personal information safe, payment information that you have on file with Express Scripts will not transfer to our new home delivery program. You’ll need to provide shipping and payment preferences before you can receive your first shipment through our new home delivery program.

  • Credit cards are preferred to allow for variations in the prices of drugs and are required when placing an order through the home delivery program. For your convenience, your credit card number will be maintained on a secured site for future orders. Other forms of payment, such as checks or money orders, can be arranged.

  • Specialty medications treat chronic conditions such as cancer, multiple sclerosis and rheumatoid arthritis. They can be an injectable, oral or inhaled medication with one or more of the following characteristics:

    • May require ongoing clinical oversight and additional education for best management.
    • May have unique storage or shipping requirements.
    • May not be available at retail pharmacies.
  • Beginning January 1, 2020, the Blue KC Pharmacy team will start partnering with Optum Specialty Pharmacy to provide specialty pharmacy services.

    Anyone who previously used specialty pharmacy services with Accredo will receive a letter and follow-up phone call with detailed transition instructions.

    On or after January 1, 2020 you can also:

    • Call 1-855-427-4682 to enroll.
    • Register online by logging into MyBlueKC.com, clicking Plan Benefits then Pharmacy Plan Info and then View Your Pharmacy Benefits. A representative will contact your doctor and take care of everything else.
  • If you take a specialty medication, our specialty pharmacy can offer extra support to help you manage your condition. Take advantage of personalized patient care from knowledgeable pharmacists and nurses who specialize in your condition—at no additional cost to you. In addition, you’ll receive:

    • 24/7 access to pharmacists
    • Support through clinical and adherence programs
    • Any medication-related supplies at no additional cost
    • Proactive refill reminders
    • Timely delivery and shipping in confidential packaging
  • A formulary (also known as a Prescription Drug List or PDL) is a list of the most commonly prescribed medications covered by your plan. The list includes both brand-name and generic prescription medications approved by the Food and Drug Administration (FDA). Medications are listed by common categories or classes and placed in tiers that represent the cost you pay out of pocket. This makes it easier for you and your doctor to find other options to help you save money.

  • The Blue KC formulary will not change beyond the traditional updates that routinely occur twice a year. Any member currently taking a drug that will be affected by any scheduled formulary changes taking effect on January 1, 2020, will be sent a letter in early November describing the change and any actions needed.

  • When a medication changes tiers, you may pay more or less for that medication, depending on the tier change. If one of your medications changes to a higher tier, talk with your doctor to decide if a lower-cost option may be available.

  • Some medications have lower-cost equivalents available. Step therapy is a process that requires you to first try more cost-effective medications before “stepping up” to medications that cost more. This process ensures you get the safest, most effective and reasonably priced medication available.

  • Prior authorization (PA) means you must get approval before your plan will cover your medication. PA is used to make sure the medication you’re taking is appropriate and effective for your condition. To start the prior authorization process, your doctor can access BlueKC.com. Your doctor will need to provide more information about why you are taking a medication.

  • Most unexpired prescriptions that have previously received prior authorization will transfer to our new home delivery and specialty pharmacy programs. To help prepare for the transition, we recommend that you have a one-month supply of your current medications available.

  • We’ll continue to offer the same great access to fill prescriptions at thousands of retail pharmacies and many national drug stores, supermarkets and large retailers. When you fill a prescription through a participating pharmacy, show the pharmacy your most current ID card so they can submit a claim for coverage by your pharmacy benefit plan.

  • Anyone who will be impacted by network changes in 2020 will receive a letter with detailed transition instructions and alternative pharmacy options.

    On or after January 1, 2020, you can also log in to MyBlueKC.com to find a network pharmacy near you, or you can call Blue KC Customer Service at the number listed on your member ID card, Monday through Friday, from 8 a.m. to 8 p.m. Central Time.

  • Please feel free to share this website with your employees as the transition to our new pharmacy benefit manager approaches. We’ve included a sample email below that can be used to make employees aware of this helpful information.

    Hello Employee,

    We wanted to inform you that beginning January 1, 2020, pharmacy benefits for your Blue Cross and Blue Shield of Kansas City (Blue KC) health plan will be administered by a new pharmacy benefit manager (PBM). The new PBM, OptumRx, is an independent company that has been contracted to provide certain services related to Blue KC's prescription drug coverage—including home delivery and specialty pharmacy services. If you have any questions about this change, we encourage you to visit BlueKC.com/pharmacy where you'll find the most current information about pharmacy programs and benefits offered. The site includes network details, a pricing overview, Frequently Asked Questions and more.

Questions?

If you have questions about this information, or your pharmacy benefits in general, please call Blue KC at the number listed on your member ID card, Monday through Friday, from 8 a.m. to 8 p.m. Central Time.