• Prescription Drugs

Prescription Drug Coverage

Each of the medical plan options includes prescription drug coverage. The cost you pay per prescription is determined according to a six-tiered drug classification designed to make your prescriptions more affordable—including certain generic medications for only $5. Please note, prescriptions for quantities of 90 days must be purchased through the Mail Service Pharmacy or at a CVS retail location. Please watch this 8-minute video for more important details on the prescription drug program. You can also review this Pharmacy Resource Guide.

Note: Under the Value HSA or Super Value HSA, you must satisfy your medical plan annual deductible before prescription drug coverage begins, unless the drug is included on the HSA Preventive Drug List. However, you can use HSA funds to help pay for expenses applied toward your deductible. The tiers include:

Tier Description
Tier 1 Low-Cost Generics

You pay just $5 for any prescription drug in Tier 1. Tier 1 drugs contain the same active ingredients as their brand-name counterparts.
Tier 2 Higher-Cost Generics

These drugs contain the same active ingredients as their brand-name counterparts.
Tier 3 Preferred Brands

These drugs are primarily brand-name drugs without generic equivalents. In some cases, Tier 3 may also include generic drugs that have lower-cost or over-the-counter alternatives.
Tier 4 Non-Preferred Brands 

Tier 4 is primarily made up of  non-preferred brand-name drugs. Tier 4 may also include some generic drugs that have lower-cost or over-the-counter alternatives available.
Tier 5 Preferred Specialty

This tier includes preferred brand specialty drugs. Specialty medications are only available in 30 day supplies from one of Blue Cross Blue Shield of Mass’s preferred specialty pharmacy partners.
Tier 6 Non-Preferred Specialty

This tier includes non-preferred brand specialty medications. These are only available in 30-day supplies from one of Blue Cross Blue Shield of Mass’s preferred specialty pharmacy partners.

Find a Pharmacy

Visit www.caremark.com/wps/myportal/PHARMACY_LOCATOR_FAST.

Check Your Medication’s Tier

Visit member.bluecrossma.com to:

  • Access the BCBS drug lookup tool
  • Learn more about the prescription drug program
  • Get an up-to-date list of formulary medications

Learn More

Review the MAPFRE Prescription Member FAQ.

Learn More

BCBS of MA

800-262-2583

www.bluecrossma.org

Plan Documents

Mail Order

Save on your maintenance medications when using the Mail Service Pharmacy!

Maintenance medications, also known as long-term medications, are used to treat chronic or ongoing conditions. Save when you order them in 90-day supplies through the Mail Service Pharmacy. There is no additional cost for standard delivery and signing up for automatic refills makes it less likely to miss a dose. Register and then sign in to MyBlue to access the Mail Service Pharmacy website. You will be required to add your billing information.  Don’t forget to enroll in auto-refill and to select your communication preferences. You can also enroll in the Mail Service Pharmacy or fill prescriptions by calling 1-877-817-0477.

Please note: Certain medications that require immediate administration or are used for short periods of time are not available through the Mail Service Pharmacy. In addition, some specialty medications are only available through specific BCBS specialty pharmacy partners. Also, certain prescribed medications may be subject to dispensing limitations. If you have any questions about your medication, call Customer Care at 1-877-817-0477.

Click here to access a Mail Service Order Form.

Specialty Medications

Specialty medications are available in 30 day supplies and must be obtained from one of four Blue Cross Blue Shield of MA preferred pharmacy partners.  For more details on specialty medications, click here.

Affordable Care Act Medication List

Affordable Care Act Medication List

Applies to all three plans. Any applicable cost share (deductible, coinsurance or copay) would be waived for the medications on this list.

Health Savings Account Preventive Medication List

Health Savings Account Medication List

Applies only to the Value and Super Value Plans. Waives the deductible, but a member is still responsible for cost share after deductible (i.e., applicable copay).

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