Optimize Your 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.

Find a Network Pharmacy

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.

Pharmacy Network Names

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.

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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 is available. To access, 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.

  • You have two ways to access your Blue KC pharmacy benefits information online:

    1. Login to MyBlueKC.com, click on Plan Benefits found on the left side of the page, then click on Pharmacy Plan Info and then the View Your Pharmacy Benefits button.
    2. You can also login directly to the our pharmacy benefit manager website. The first time you visit the website click the Register button. You will need to provide your name, date of birth, ZIP Code and Blue KC member ID number. Your Blue KC member ID can be found on the Blue KC member ID card.
  • 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
  • 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.

  • 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
  • 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.
  • 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.

  • 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.

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.