Prescription Coverage - PPO Savings Plan
The Pharmacy Benefit Manager for Highmark Blue Shield is Express Scripts.
Prescriptions may be obtained from any Express Scripts-participating pharmacy, including retail pharmacies for up to a 31-day supply, or mail-order pharmacies for up to a 90-day supply.
To view the drug formulary, a list of participating pharmacies, and price comparisons for 31-day and 90-day supplies of generic and brand-name medications, or to order refills of prescription medications, please see the Prescriptions tab on the Highmark website.
For questions regarding prescription benefits or claims, please contact Highmark Blue Shield at 800-914-4384
- Drugs that are purchased at a local participating pharmacy
- Maximum supply available is 31 days
Generally, the retail method is used for short-term prescriptions, such as an antibiotic. While maintenance drugs can be purchased on a retail basis, the maintenance prescription drug plan is more cost-effective.
Mail Order Maintenance Prescriptions
- Drugs that are prescribed for the long-term treatment of a condition
- Maximum supply available is 90 days
Maintenance drugs are available from Express Scripts and from the University Health Services (UHS) Pharmacy. Refills may be ordered online and by phone.
Drugs purchased through Express Scripts will be delivered to the member's home address. Drugs purchased from University Health Services Pharmacy can be delivered by campus mail at no cost or by U.S. Mail to the member's home for a $3.00 fee.
Specialty medications are typically self-administered injectable, biological agents, biotechnology medications and other prescriptions that are not available at most pharmacies.
- Walgreens Specialty Pharmacy is the exclusive provider for certain specialty medications
- Dispensed in one-month supplies
- Cost of specialty medications is applied to deductible; once deductible is met, 10% co-insurance applies
- Overview of PPO Savings Plan Coverage
- University Health Services Prescription Mail Order Form
- Highmark Drug Formulary
- Highmark Prescription Drug Cost Calculator - log into site, select the "Prescriptions" tab, and then click on "Costs and Savings"