Prescription Drug Benefits
Your Employee Self Service
You can manage your information at home by logging into Employee Self Service through Remote Access.
You will automatically be provided with prescription drug coverage when you elect any of the medical plan options. For the NHRMC Plan and the Standard Plan, the rates shown in the chart below will apply to all prescription drug purchases. To obtain a listing of the participating pharmacies, generic equivalents and drug tier levels, go to www.bcbsnc.com.
2017 Medicare Part D Creditable Coverage Notice
Mandatory Generic Drug Policy
Many prescription drugs are available as both a brand name drug and a generic name drug. By law, generic drugs must meet the same standards for safety and effectiveness as brand name drugs. Obtaining generic drugs whenever possible can provide you with direct savings because you pay a lower co-pay. It also provides you with indirect savings because you save the plan money, which ultimately benefits you.
When you have a prescription filled, you will receive a generic substitute whenever possible. If there is not a generic equivalent available, tier pricing will apply. If you choose to receive the brand name drug and a generic equivalent is available, you will pay the difference between the full cost of the generic and the brand-name drug, plus the tier co-pay.
Prescription Drug Benefits
Any BCBSNC In-Network Pharmacy
- Tier 1 30‐Day Supply $4
- Tier 2 30‐Day Supply $20
- Tier 3 30‐Day Supply $40
||Mandatory Mail Order Maintenance Medications**
||Prescription Drug 90-Day Supply
|Tier 1 90-Day Supply
||co-pay at 2 1/2 times ($10)
|Tier 2 90-Day Supply
||co-pay at 2 1/2 times ($50)
|Tier 3 90-Day Supply
||co-pay at 2 1/2 times ($100)
Maintenance Medication by Mail
Through December 31, 2017: PrimeMail by Walgreens is the home delivery pharmacy for maintenance medications. These are medications you take regularly for more than 3 months to treat chronic conditions such as high cholesterol or high blood pressure, as well as asthma, depression and anxiety. After filling a prescription for a maintenance medication twice for 30-day refills, members are required to fill future prescriptions for that drug through PrimeMail by Walgreens for a 90-day supply. Failure to do so will result in a $20 penalty on each subsequent supply.
Beginning January 1, 2018: Medimpact will be NHRMC’s prescription benefit administrator. Additional details about filling maintenance medication prescriptions will be provided shortly.
NHRMC Outpatient Pharmacy
You may purchase over-the-counter medicine at highly discounted rates, including ibuprofen, acetaminophen, antihistamine, cough medicine and smoking cessation aids.