Blue KC provides several ways to fill prescriptions. Your coverage also includes services to help you make the most of your pharmacy plan, and in some cases can help you save money. Below you’ll find helpful information regarding your pharmacy benefits.
Fill your prescriptions at thousands of retail pharmacies and many national drug stores, supermarkets and large retailers.
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.
Our specialty pharmacy can help you manage your chronic conditions and specialty therapies. To learn more, visit our Specialty Pharmacy FAQ page.
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.
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). along with their tier level.
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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.
To help you plan for future pharmacy costs, utilize the drug pricing link to obtain average pharmacy prices that would apply outside of a copayment or coinsurance per Rx.
Disclaimer: Medication prices, individual retail pricing, and coverage may vary. Pharmacist’s judgment, your doctor’s instructions on how to take the medication, and law may impact the dispensed quantity and/or days’ supply you may receive. The coverage and pricing terms of products are subject to change based on your Pharmacy benefits. Information provided in this link is not a guarantee of coverage.
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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:
Our home delivery program is a convenient, cost-effective and safe option for getting medications you take regularly.
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:
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.
Ask your specialty pharmacist if there are any financial help programs available for your drug. Sometimes the manufacturer offers help with the cost.
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:
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:
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.