0000085055 00000 n Your ID cards will come from our medical and dental vendors (i.e., Highmark Blue Cross Blue Shield and Cigna). 0000006744 00000 n 0000008578 00000 n Once Highmark Blue Shield receives a claim, it will electronically route the claim to the member's Blue Plan. After that, all Personal Data will be deleted or the documents with such data will be anonymized. Your Highmark Wellness Rewards Prepaid Mastercard will be mailed directly to you following the processing of your claim. 0000004150 00000 n Premier Pharmacy NetworksThe prescription drug program offers a wide network of pharmacies and various pharmacy networks, including most national chains and many local, independent pharmacies. To view the Highmark Medicare-Approved Select/Choice Formulary for Medicare Advantage or BlueRx members, click here. Get care for your physical and mental well-being, including prescription drug coveragefrom the doctors, hospitals, and pharmacies you need. 0000001979 00000 n You must complete a separate claim form for each pharmacy used and for each patient. Advantages of Using the Mail Order . 0000018991 00000 n Our vision is to ensure that all members of the community have access to affordable Highmark Blue Shield serves the 21 counties of central Pennsylvania and also . Non-individual members Sign in to Availity to submit prior authorizations and check codes. With Highmark Blue Cross Blue Shield of Western New York, getting and staying healthy is now more affordable with our nationwide wellness debit card benefit. Got a Question? Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. FIND A DOCTOR OR PHARMACY. Forgot Username Select Language; Select Language Utilization Management Preauthorization Form: Outpatient Services. Any subsequent refills do not require an order form. Language Assistance. (i) when required or permitted by law or government agencies. The member can have one of the prescriptions filled at a local pharmacy to begin taking the medication immediately. 0000009767 00000 n Providers in need of assistance should contact provider services at 800-241-5704 (toll-free). Advantages of Using the Home Delivery ServiceMembers may prefer to use the home delivery prescription service. Security | Privacy | Terms of Use | Notice of Non-Discrimination and Translation Assistance, Notice of Non-Discrimination and Translation Assistance, If this is your first time visiting, youll need to take a moment to register. Pharmacy Benefits for FreedomBlue MembersCopayments and coverage limitations vary depending on the region, group, and/or direct-pay enrollment. Testosterone Product Prior Authorization Form. 4. Call 1-877-298-3918. (iii) for purposes relevant to corporate policies or litigation to the extent permitted under applicable law or when it is prescribed in GDPR or other applicable law. The Use this form to determine if a service or item requires prior authorization from the health plan before you receive care. Call Highmark Member Service at the number on the back of your Highmark Member ID card, seven days a week from 8 a.m . fenty beauty how many carats; iphone usb driver windows 11 64bit Prior authorization requests are submitted on different websites for Individual and non-Individual plan members (groups, associations, etc.). Always present your prescription drug ID card at the participating retail pharmacy. These service providers will be bound by sufficient guarantees to implement appropriate technical and organizational measures in such a matter that their processing will meet the requirements of applicable law. Notwithstanding the above disclosures, we will disclose the Personal Data we collect from you under the following circumstances: We use third-party service providers to process Personal Data, including, without limitation, for information storage and other similar purposes. I am a: Member / Patient Provider Member Group Number The member group number is located on the Blue Cross and Blue Shield of Minnesota member ID card. Your Personal Data will be disclosed to appropriate personnel for purposes of performing services to, or on behalf of, our enterprise customers and prospective customers as part of and in relation to matters regarding our provider, health plan, and subsidiary enterprise care delivery, administration and operations. For those members, the Express Scripts logo appears on the member's ID card. 0000002426 00000 n The drug formulary is then divided into major therapeutic categories for easy use. 0000017131 00000 n 0000017108 00000 n Additionally, Accredo has specialized pharmacists who know and understand your conditions. Notwithstanding the above disclosures, we will disclose the Personal Data we collect from you under the following circumstances: We use third-party service providers to process Personal Data, including, without limitation, for information storage and other similar purposes. Home delivery service is an option that groups may select depending on their benefit design. Accredo will mail your specialty medications to your home or another secure location. After that, all Personal Data will be deleted or the documents with such data will be anonymized. Dependent and PCP Information , if applicable 4. Rx group number and pharmacy logo -This will be on the ID card whenever a Highmark prescription drug program is included. 0000006767 00000 n Up to a 90-day supply of each covered medication (compare to a typical retail 30-day supply) Online refill reminders. Providers. Plus, get coverage for vision care, dental care, hearing aids, and more. Enrollment in Highmark Choice Company, Highmark Senior Health Company, Highmark Senior Solutions Company, Highmark BCBSD Inc., Highmark Western New York and Northeastern New York Inc. and Highmark Health Insurance Company depends on contract renewal. (TTY/TDD: 711) Monday through Friday. 0000009593 00000 n 4. Your email address and phone number may be used to contact you. Questions on or after January 1, 2022:. Member Identification Information 3. 0000018968 00000 n 3. Specialty Drug Request Form. Other Coverage for Pharmacy BenefitsSome members of SelectBlue and PPO Blue may have other prescription drug coverage that is not administered by Highmark. The Highmark P&T Committee approves revisions to the drug formulary on a quarterly basis; updates will be provided to reflect such additions. You have access to wellness-related products and services nationwide, so don't forget to take your card with you when traveling. Highmark's Medical and Pharmacy Affairs department monitors provider-specific formulary prescribing and communicates with providers to encourage use of formulary products. We will retain the information in our system in accordance with applicable law and our Data Protection Policy:https://www.highmark.com/hmk2/gdpr.shtml. At Highmark Blue Cross Blue Shield of Western New York, we've built our legacy around empowering our communities and helping you be your very best you. To obtain a copy of the formulary, contact your Provider Relations representative. 0000003884 00000 n 0000004173 00000 n *If you are aMedicaidorChild Health Plusmember, pleaselogin here. For those members, the MedcoHealth logo appears on the member's ID card. Most prescription drugs are covered when provided or authorized by the PCP on an outpatient basis and obtained at a Premier contracting pharmacy. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. DISCOVER. Read each plan summary carefully a drug's formulary status may affect how much you pay. @ Need Help? 0000011828 00000 n These services providers are located in the United States. Fax to (716) 887-7913 . Your Personal Data will remain on file for: any period required by applicable law; and, to the extent necessary for any purpose(s) provided directly or indirectly herein or as may be reasonably inferred from the content contained in this notice or the website, but no longer than permitted by applicable law. We want to clarify these ID card changes for you so you can best . This information will be used for purposes of performing services to, or on behalf of, our enterprise customers and prospective customers as part of and in relation to matters regarding our provider, health plan, and subsidiary enterprise care delivery, administration and operations. Highmark Blue Shield also provides services in conjunction with Blue Cross of Northeastern Pennsylvania in northeastern Pennsylvania and Independence Blue Cross in southeastern Pennsylvania. For members with a Highmark Select or Highmark Choice formulary benefit, non-formulary drugs are not covered under a Select formulary benefit or will require a higher co-payment under a Choice formulary benefit. Download the latest version to access the site. Members may call the Member Services telephone number on their identification card to find out if they have home delivery coverage. 0000003271 00000 n Please consult your plan documents for details or call customer service. 0000013562 00000 n These services providers are located in the United States. You also explicitly consent to the automated decision making by us, which may include the processing of your health data, to the extent that it is necessary to process your health claim swiftly and efficiently. This page gives you a brief overview of Highmark's Pharmacy Benefits Program and information on the following topics: Pharmacy Benefits for Managed Care MembersHighmark administers prescription benefits for almost all members. 0000009156 00000 n trailer << /Size 476 /Info 430 0 R /Root 434 0 R /Prev 226046 /ID[<28eed5e12dc9f0cb186d0c2fa4c97d48>] >> startxref 0 %%EOF 434 0 obj << /Type /Catalog /Pages 432 0 R /Metadata 431 0 R /Outlines 16 0 R /OpenAction [ 436 0 R /XYZ null null null ] /PageMode /UseNone /PageLabels 429 0 R /StructTreeRoot 435 0 R /PieceInfo << /MarkedPDF << /LastModified (D:20030516122738)>> >> /LastModified (D:20030516122738) /MarkInfo << /Marked true /LetterspaceFlags 0 >> >> endobj 435 0 obj << /Type /StructTreeRoot /ClassMap 34 0 R /RoleMap 36 0 R /K 327 0 R /ParentTree 421 0 R /ParentTreeNextKey 6 >> endobj 474 0 obj << /S 67 /O 172 /L 188 /C 204 /Filter /FlateDecode /Length 475 0 R >> stream Exclusions Apply. If you have questions about Medi-Cal Rx , call the Medi-Cal Member Help Line at (800) 541-5555 [TTY: (800) 430-7077], Monday through Friday, 8 a.m. to 5 p.m. Applies only to fully insured and community-rated groups. Front of Card Back of Card Highmark Blue Cross Blue Shield Delaware is an independent licensee of the Blue Cross and Blue Shield Association . Drugs are listed by brand and generic names. Stand-alone dental and prescription drugs . Highmark Western and Northeastern New York Inc., serves eight counties in Western New York under the trade name Highmark Blue Cross Blue Shield of Western New York and serves 13 counties in Northeastern New York under the trade name Highmark Blue Shield of Northeastern New York. 0000015322 00000 n You also explicitly consent to the automated decision making by us, which may include the processing of your health data, to the extent that it is necessary to process your health claim swiftly and efficiently. The sections below provide important . Your email address and phone number may be used to contact you. For members with a Highmark Medicare-Approved Select/Choice formulary benefit, non-formulary drugs are not covered under a Select formulary benefit or will require a higher co-payment under a Choice formulary benefit. Sunosi Prior Authorization Form. Members may call the Member Services telephone number on their identification card to find out if they have home delivery coverage. or 0000008651 00000 n Suitcase logo - Indicates a member of the BlueCard program. You can contact them for any questions you may have regarding your condition, the specialty medication, and/or any side effects you may be experiencing. Sign in to the appropriate website below to complete your request. Phone: 1 -800 677 3086. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Enrollment in Highmark Choice Company, Highmark Senior Health Company, Highmark Senior Solutions Company, Highmark BCBSD Inc., Highmark Western New York and Northeastern New York Inc. and Highmark Health Insurance Company depends on contract renewal. . (It is recommended that this prescription be written for a two-week supply.) This program may not be applicable to all members. Physicians are requested to prescribe medications included in the formulary whenever possible. We do so by offering health plans that provide reliable coverage to Western New Yorkers and by supporting the organizations and individuals who work hard every day to keep our communities healthy. 0000053660 00000 n 0000053581 00000 n 2. 0000010006 00000 n All fields are required. The following outlets do not participate in our wellness debit card program: Pharmacies, sporting goods stores, grocery stores, doctor's offices, optometrists, salons, and department stores. Highmark Member Site - Welcome. Forgot Password, Whether you fill your prescriptions at a local pharmacy or have them delivered, our tool helps you select the lowest-cost pharmacy, identify lower-cost alternatives, and compare brand-name and generic costs.1, You can save both time and money with mail-order prescriptions through the Express Scripts home-delivery program. Eligibility, Usage, Activation, Products and Services. Hb```f``[9A@l(GwF\ VbqIBL230[1c43? Select Language ; Select Language; Font size dropdown. All FreedomBlue coverage includes at least the same services as those provided by Medicare. 0000004120 00000 n 0000001566 00000 n Weight Loss Medication Request Form. Not subject to a deductible. Blue Cross, Blue Shield and the Blue Cross and Blue Shield symbols are registered marks of the Blue Cross Blue Shield Association, an association of independent Blue Cross and Blue Shield companies. This website works best with Internet Explorer 7 and . Mail order savings may not apply to all plans. Forgot username or password? 0000020754 00000 n Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. The formulary is designed to assist in maintaining the quality of patient care and containing cost for the patient's drug benefit plan. Date: October 22, 2021. This committee is comprised of network physicians and pharmacists who select products on the basis of their safety, efficacy, quality and cost to the plan. 0000082377 00000 n 0000001704 00000 n Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties . 2. The drug formulary is divided into sections based on the member's plan benefit design. 0000002001 00000 n You now have one card for both your medical and prescription benefits. Networks and drug benefits may vary slightly, depending upon the member's group and/or managed care program. Please review your benefit summary documents or contact customer service, Nearly 80% of prescriptions filled in the U.S. are generics, They work just like brand-name medications and have the same active ingredients, Many generics are manufactured by the same company that makes the brand-name medications, Generics are of the same quality, strength, and purity standards as non-generic. 0000002467 00000 n Managed care members must use one of the participating pharmacies in Highmark's Premier Pharmacy networks. 0000006499 00000 n 0000008906 00000 n If you have questions regarding how we process your Personal Data and what we store about you, please contact PrivacyInternational@HighmarkHealth.org or write us: By agreeing to the terms and conditions set out in this Data Protection Statement, and by providing us with your Personal Data, you consent to the collection, use and disclosure of any information you provide in accordance with the above purposes and this Data Protection Statement. That list will vary depending on the plan you choose. All references to Highmark in this document are references to the Highmark company that is providing the members health benefits or health benefit administration. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. The purpose of this Data Protection Statement is to notify you of the practices that will govern the processing of your personal data and to obtain your explicit consent for the processing of your personal data consistent with it, in particular in accordance with the legal requirements of the European Unions (EU) General Data Protection Regulation (GDPR): The personal data collected may include your address, city, postal code, country, phone number, email address, IP address, as well as any other personal information you choose to provide (Personal Data). This program may not be applicable to all members. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. All reasonably appropriate measures will be taken to prevent disclosure of your Personal Data beyond the scope provided directly or indirectly herein or as may be reasonably inferred from the content contained in this notice or the website. Highmark is not responsible for lost or stolen cards. Information on this website is issued by Highmark Blue Cross Blue Shield on behalf of these companies, which serve the 29 counties of western Pennsylvania and are independent licensees of the Blue Cross and Blue Shield Association, an association of independent Blue Cross Blue Shield plans. For refills, the member can call the toll-free number, send in the refill form with the applicable co-payment, or visit Highmark's web site at www.highmarkblueshield.com. This information will be used for purposes of performing services to, or on behalf of, our enterprise customers and prospective customers as part of and in relation to matters regarding our provider, health plan, and subsidiary enterprise care delivery, administration and operations. Highmark Health Insurance Company is a PDP plan with a Medicare contract. To view the Highmark Select/Choice Formulary, click here. 433 0 obj << /Linearized 1 /O 436 /H [ 1704 297 ] /L 234836 /E 120964 /N 6 /T 226057 >> endobj xref 433 43 0000000016 00000 n (i) when required or permitted by law or government agencies. Products are removed from the formulary twice a year, January 1st and July 1st, after a minimum of 30 days notification is given to providers. Pharmacists available 24/7 to answer your questions. SAMPLE OF A MEMBER ID CARD 1. 0000006046 00000 n Highmark Blue Cross Blue Shield of Western New York is a trade name of Highmark Western and Northeastern New York Inc., an independent licensee of the Blue Cross Blue Shield Association. All reasonably appropriate measures will be taken to prevent disclosure of your Personal Data beyond the scope provided directly or indirectly herein or as may be reasonably inferred from the content contained in this notice or the website. Highmark Health Insurance Company is a PDP plan with a Medicare contract. Use this form when you have paid full price for a prescription drug at a retail pharmacy. The Highmark Medicare-Approved Prescription Drug Formulary is a list of all covered Part D drugs. 4yxWn8l?W~i1vu+~u^]lY]9\ Os lL&bk2W'ZNQWRM.S A& ISMvbCp-bj'-IW7>}>I7jl Pharmacies have point-of-sale technology that confirms a member's eligibility, benefit design and copayment information at the time of dispensing. Over the next few months, we will begin issuing new Highmark ID cards to your patients. Please consult your plan documents for details. At Highmark Blue Cross Blue Shield of Western New York, we do our best to ensure members have the best wellness options available to get . For anything else, call 1-800-241-5704. . Mandatory Generic FeatureMany plans include a mandatory generic provision, which requires that if the generic drug exists but the member or physician specifically requests the brand name drug, the member will have to pay the brand name copayment and the cost difference between the brand name drug and the generic drug. Last updated on 10/24/2022 10:44:11 AM. Notes: This consent is given voluntarily and can be revoked at any time in writing by sending an email to PrivacyInternational@HighmarkHealth.org If you want to exert your withdrawal right or your rights to access, rectify, block, transfer or delete your personal data pursuant to the GDPR, please contact us and provide us at least with your full name, address and the data processing you are inquiring about. Medical and Rx Claims Processing Information 5. For those members, the MedcoHealth logo appears on the member's ID card. Most dosage forms and strengths of a drug are included in the formulary. (ii) when required valid requests by law enforcement. %IVVq+h Do not use this mailing address or form for provider inquiries. The member can send the other prescription to the home delivery service for up to a 90-day supply. %PDF-1.3 % Refill requests online, by mail, or by phone anytime, day or night. For some plans with a mandatory generic provision, if a member requests the brand name drug, but the prescription does not specify "brand medically necessary," the member will be required to pay the difference in cost between the brand drug and the generic drug, in addition to the applicable brand name copayment. The Hi- Mark Bar 3229 Riverside Dr. Cincinnati, OH 45226 East End 513-492-7119 Order Carryout Order Delivery Wednesday Trivia 7pm / Hi- Mark Trivia hosted by Moichman Current Hours Last Updated 10:15am 6/7/2022 Outdoor Dining, Indoor Dining, Carryout and Delivery Monday-Thursday 4pm-11pm Friday 4pm-12am Saturday Noon-12am Sunday Noon-10pm. A prescription drug list or formulary shows which drugs are covered by each insurance plan. W[=v@!&mbu+ XN_ [O>&A!X*&h}r~/P$"l~[GQvw4q6,J. membership identification card. z g@t Mail-order Benefits. Licensed Product Name 2. The prescription drugs on this list are selected by a team of doctors and pharmacists and are updated on an on-going basis. The Highmark Drug Formulary is a list of FDA-approved prescription drug medications reviewed by our Pharmacy and Therapeutics (P&T) Committee. 0000001211 00000 n Highmark administers prescription benefits for almost all members. 0000100729 00000 n (Some direct pay benefit plans are not available in every region.) 2022Highmark Blue Cross Blue Shield of Western New Yorkis a trade name of Highmark Western and Northeastern New York Inc., an independent licensee of the Blue Cross Blue Shield Association. After January 1, 2022: benefit administration obtained at a local pharmacy to taking! Medication ( compare to a typical retail 30-day supply ) Online refill reminders to be the leading health and company. Selected by a team of doctors highmark bcbs prescription card drugs - Highmark < /a > Mail-order.! 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