Yes, up to two years of your prescription claims history is available. To access, log in to your member account to reach Plan Benefits and your pharmacy plan information.

Blue KC’s pharmacy benefit site allows you to quickly enter the name of the medication you’re taking or interested in, and search results will clearly tell you whether or not a medication is covered by your plan and / or requires prior authorization. If a medication is not covered, you will see alternatives to consider that are also used to treat your condition. Please note: Your plan will not typically contribute towards the cost of your prescription until you have met your plan’s deductible. Log in to your member account to start your search.

As an alternative, you can access all the Prescription Drug Lists below. But remember it is best to log in to your account to check your specific prescription drug list:

Employer-Covered members: View prescription drug list here

Individual & Family plan members: View prescription drug list here

To have a prescription refilled early, have your pharmacist call the Pharmacy Customer Service unit at 816-395-2176 or 800-228-1436, Monday through Friday from 8 a.m. to 5 p.m. Central Time.

Yes, show your member ID card to your pharmacist whenever you have a prescription filled. Your prescription claim is electronically transmitted to Blue KC when you fill your prescription. Please make sure the pharmacy has your most current health insurance information and correct birth date so there won’t be any delays or claim denials when we process your claim.

A maintenance drug is a medication used to treat a chronic condition like diabetes or high blood pressure. The FDA must approve maintenance drugs as safe for long-term use. Blue KC uses a national drug information database called First DataBank to determine which medications are included on the maintenance drug list. If your prescription is a maintenance drug, you can have it filled for several months instead of just one prescription at a time.

A generic equivalent is a medication that contains the same active ingredient and works the same way as the original brand name drug. A generic alternative is a generic medication that may not have the same active ingredient, but works in the same way as another drug. An example of a generic alternative is ranitidine. It is the generic equivalent of Zantac®, but it works in the same way to relieve stomach acid as Axid® and Pepcid®.

Zantac, Axid, and Pepcid are the same “class” of medicine but contain different active ingredients. So, the generic form of Zantac, “ranitidine,” is a lower cost alternative in the same class of medicine as Axid and Pepcid.

When a drug company develops a new medication they apply for a patent. This patent protects the drug from being copied by other drug companies for a certain period of time. These drugs are brand name drugs. Once the patent period expires, other manufacturers can produce the same drug as long as they follow strict guidelines established by the Food and Drug Administration’s (FDA) guidelines. These same drugs are generic drugs. Generic drugs are less expensive versions of those brand name drugs whose patents have expired. They are made with the same active ingredients of the brand name drug, but they may have a different color, shape or filler material. The cost of a generic drug is typically less than a brand name drug. All generic medications are approved by the FDA before they are released on the market. Some examples of generic drugs and their brand name equivalent include furosemide and Lasix®, ranitidine and Zantac®, and cephalexin and Keflex®.

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.

Blue KC’s pharmacy benefit site allows you to search for weight-loss medications and view related coverage and cost information. Enter the name of the medication you’re taking or interested in, and search results will clearly tell you whether or not a medication is covered by your plan. If covered, most weight-loss medications do require you to obtain prior authorization, which your doctor can submit to Blue KC for you. Log in to your member account to start your search.

Log in to your Blue KC member account to reach the Pharmacy page.

If you have questions about this information, or your pharmacy coverage in general, please call the pharmacy customer service line listed on your Blue KC member ID card.