Rx Tools
Pharmacy Guide
Table of Contents
Using a Retail Pharmacy
Finding a Participating Retail Pharmacy
Our pharmacy network consists of more than 55,000 pharmacies in Wyoming and across the country. Choosing a pharmacy in our network will provide you with convenient pharmacy services and access to more affordable medications.
When you use a pharmacy that is not in our network, you pay the full cost of your prescription up front. You will also have to submit a claim to get reimbursed. Reimbursement for prescriptions filled at non-network pharmacies is not guaranteed.
How to Fill a Prescription at a Retail Pharmacy
Getting your medications at any of the 55,000+ pharmacies in our pharmacy network is easy. Simply present your prescription and BCBSWY ID card to the pharmacist. Your benefits are applied automatically so you know right away what out-of-pocket costs may be your responsibility.
If you go to a pharmacy that is not in our network, you pay the full cost of your prescription up front. Then you can file a claim with BCBSWY for reimbursement. You may be responsible for amounts exceeding allowable charges. Check your benefit booklet for more information.
Preferred Drug List (Formulary)
A preferred drug list or formulary is a list of prescription drugs and supplies that have been selected to give you the best results while saving you the most money. You can buy a drug that is not on the list, but you may pay more. Ask your doctor to prescribe medications from your formulary when possible.
Who decides which drugs go on the list?
The Pharmacy and Therapeutics (P&T) committee makes decisions about the drug list. This committee is made up of doctors and pharmacists. These drugs meet clinical standards for safety, effectiveness, uniqueness and cost.
Drug Cost Estimator
It may be possible to reduce your overall prescription drug costs. Consider these suggestions:
- Ask about generic drugs. They can deliver better value than brand name drugs, working in the same way and costing less. Generic equivalents are considered by the FDA to be comparable to brand name drugs in:
- Dosage form
- Performance
- Quality
- Safety
- Strength
- Usage
- Use mail-service. Fill your prescription through your mail-service pharmacy.
- Talk to your doctor or pharmacist.
- Ask your doctor to prescribe drugs on the formulary when possible.
- Review all medications you are currently taking with your doctor; you may not need them all.
- Talk to your doctor about a lower dose.
- Ask if you may be taking similar medications without knowing it.
- Ask about switching to over-the-counter alternatives.
This information is not a substitute for recommendations from your doctor.
Mail-Service Pharmacy
- Save time and money filling routine prescriptions
- Delivery to home or other location
- Get a 90-day supply
- Auto-refills available
- Free standard shipping
Check your Benefit Booklet for more information.
Prime Therapeutics LLC (Prime) is an independent company that manages pharmacy benefits for Blue Cross Blue Shield of Wyoming members.
Specialty Pharmacy Program
Specialty medicines treat chronic (long-term) or rare conditions. Examples can include rheumatoid arthritis, Crohn’s disease, multiple sclerosis, cystic fibrosis, cancer and hepatitis C. With the Specialty Pharmacy Program, you can get the medicines and support you need to help manage your specialty condition.
Advantages of using the Specialty Pharmacy Program
- Medicine delivery: Count on receiving your medicines and supplies on time, when and where you need them.
- Insurance: Your claims are filed for you.
- Support: You’ll have 24/7 support from nurses, pharmacists, and specialty-trained staff experienced in your specific medicines and specialty condition.
- Assistance: One-on-one counseling, help coordinating treatment and benefits, and assistance understanding how to take and store medicine is available at no additional cost.
Check your Benefit Booklet for more information.
Prime Therapeutics LLC (Prime) is an independent company that manages pharmacy benefits for Blue Cross Blue Shield of Wyoming members.