Prescriptions

  • pharmacist helping customer

    Get the specifics on your drug coverage

    Whether you need a refill, want to compare drug prices, or just want plan-specific information about your coverage, logging in is the quickest way to get the most accurate information.

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  • 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
  • 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.

    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 go to Pharmacy Services.
    • 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 go to Pharmacy Services, 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.

    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.

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