About Pharmacy

  • Your pharmacy benefits

    Our pharmacy benefit offers many convenient services including a mail-order option.

    Prescription drug coverage is important to your health. Premera’s pharmacy benefit is designed to help you get the medicine you need—while saving you money whenever possible. Pharmacy benefits are coordinated through our partner, Express Scripts.

  • Forms

    • Health, allergy, and medication allergy questionnaire
    • Complete this questionnaire for all new mail prescriptions to help protect yourself against potentially harmful side effects and medication interactions.
    • Drug interaction form
    • Secondary coverage claims
    • Are you covered by more than one health plan, with Premera as your secondary coverage? If so, you can request reimbursement for the balance of your prescription costs.
    • Secondary insurance drug claim form
  • Most common questions and answers

    For the most accurate information, log in and search for your specific drug. You can find out if it's covered, how much it costs, and whether it requires pre-approval from your healthcare provider.

    For the most accurate information,log in and search for your specific drug.

    There are hundreds of different medications, with more becoming available every day. We require that you obtain preapproval from us for medications in 3 cases:

    • There are alternative drugs on the drug list
    • The drug has a high potential of inappropriate use, or
    • There are safety concerns for the drug

    If you don't obtain pre-approval, the medication may cost more, or we may not cover it. You can search for your drug and see if requires your doctor or healthcare provider to submit a pre-approval form.

    There are 3 common reasons the cost of your prescription may increase:

    • Prescription drug coverage may change over time. Consult your benefit guide to learn about what costs you're responsible for paying.
    • There's a change to the list of covered drugs. This list is sometimes referred to as a formulary. A change in this list can result in prescription drugs moving to a new coverage levels. (Prescription drugs are categorized into coverage levels, each with a different copay or out-of-pocket amount.) This can happen if you're taking a brand name drug and a then generic version of that drug is made available. For the most accurate information, log in and search for your drug.
    • The drug price increases, and we cover a percentage of the drug's cost (and you're responsible for the remaining percentage - the coinsurance. Like everything you buy, drug prices may increase. If the drug you're taking is on a drug level for which you're required to pay coinsurance, your out-of-pocket cost will also increase.

    To receive the highest coverage under your plan's prescription benefit, use a pharmacy that's part of the Premera network. There are more than 60,000 in-network pharmacy locations nationwide. Log in and find a participating pharmacy using our provider directory, or call the 24-hour pharmacy locator number on the back of your member ID card.

    Learn more about in-network care.

    You can also use our in-network prescription mail-order service.

    Yes. Mail order offers maximum convenience and value through Express Scripts® Home Delivery Pharmacy. There's an easy 2-step process to start receiving your prescriptions through the mail:

    1. Provide Express Scripts your information, including your mailing address and payment information. You can do this online with the Express Scripts form, or you can download and complete a pharmacy mail-order form. Send the form and payment to the address on the form.
    2. Ask your doctor to write your prescription(s) indicating that refills are allowed. Your doctor can send the prescription(s) electronically to Express Scripts Home Delivery Pharmacy or can give you a hard copy for you to mail.

    You'll receive your prescription by mail delivered in sealed, insulated (when necessary), and tamper-evident packaging. Refill prescriptions can then be ordered easily online through Express Scripts MyPharmacyPlus™ once you've set up your prescriptions. Or, you can call Express Scripts at 800-391-9701. Have your member ID and prescription numbers ready.

    Note: Mail order delivery can take up to 2 weeks, so be sure you have enough medication on hand. If you need your medication sooner, ask your doctor for another prescription for a 1-month supply, and fill it at a local pharmacy that's in-network.

    We offer certain preventive services, including prescription drugs at no cost to you. This means you don't have to pay coinsurance, even if you haven't met your deductible. (Typically, you start paying coinsurance after you pay your deductible.) To have the drug covered under your health plan, your doctor must write a prescription for the medication.

    • If you have a high-deductible health plan (or health savings plan, also known as an HSA), consult the Preventive Drug List for your plan to see if your drug is included in this benefit. Take this list with you when you visit your doctor to discuss your options.
    • As a part of the Affordable Care Act, there are preventive prescription and some over-the-counter medications that may be covered in full. (This does not apply to "grandfathered" plans, which means those plans that were purchased prior to March 23, 2010.)

    If you're going to be traveling, you can receive additional fills of your prescriptions by inquiring directly with your pharmacist or pharmacy. We'll work with them to get you authorized for the extra medication to ensure you can continue with the care you need.

    When you have paid a pharmacy full price for a prescription drug because you didn't have your Premera member ID card at the time of purchase, you can submit a prescription drug reimbursement form.

    In general, specialty drugs are medications that are biological, or derived from living cells. They're typically injectable or infused through a vein, although some are also taken by mouth. These drugs are used to treat complex or rare conditions such as cancer, rheumatoid arthritis, hepatitis, or multiple sclerosis. Look in the list of specialty drugs here.

    Some health plans require that you use preferred specialty pharmacies to fill your specialty drug prescription. Premera's preferred specialty pharmacies are:

    Accredo, an Express Scripts specialty pharmacy

    • If a new prescription is needed, call 800-689-6592 to enroll and ask an Accredo representative to call your provider.
    • Ask your provider to call Accredo directly at 800-689-6592.
    • Visit www.accredo.com to find out more about Accredo specialty pharmacy.

    Walgreens Specialty Pharmacy

    • Call 877-223-6447 to enroll and ask a Walgreens Specialty representative to call your provider if a new prescription is needed.
    • Ask your provider to call Walgreens Specialty Pharmacy directly at 877-223-6447.
    • Visit www.walgreenshealth.com to find out more about Walgreens Specialty Pharmacy.

    Your pharmacy benefit may require you to use our preferred specialty pharmacies to fill your specialty medications. View the Specialty Drug List to see if this applies to your medication. Log in to your Premera account and consult your benefit guide to learn if your plan requires the use of preferred specialty pharmacies.

    Specialty pharmacies work closely with you and your healthcare provider to ensure you get the most from your treatment. Specialty pharmacies may do the following:

    • Provide patient education and medication counseling
    • Work with you to assure you are taking your medications correctly and as often as prescribed
    • Research and offer patient assistance programs as needed and when available
    • Assist with pre-approval requests
    • Remind you of needed labs, if appropriate
    • Contact you to set up refills

    There are many different drug benefit options with our plans. Find out more in our pharmacy benefit guide.

    Express Scripts is an independent company providing online prescription and pharmacy services to Premera Blue Cross and Premera Blue Cross Blue Shield of Alaska members.