Saltar al contenido principal

PARA PARTICULARES Y PARA FAMILIAS

Sus beneficios farmacéuticos

Encuentre sus recetas con cobertura, formas de ahorrar y los pasos que debe seguir con su médico o farmacéutico. Already a member? Explore all of your plan's pharmacy benefits in your member account.

A mom and child checking out at the pharmacy.

Cambios en su cobertura de medicamentos recetados

Comprenda cómo pueden cambiar sus medicamentos recetados

Blue Cross and Blue Shield of Montana's drug lists are assessed and updated every year. Starting Jan. 1, 2025, some of your prescription drugs:

  • Se puede mover a un nivel de cobertura para medicamentos más alto o más bajo
  • Quizás se agreguen o se eliminen de la lista de medicamentos
  • Puede tener nuevos requisitos especiales

Listas de medicamentos

Your 2025 Drug Lists and Tiers

The 2025 drug lists are for coverage that renews or starts on or after Jan. 1, 2025. Depending on your plan, you have either a:

Search the prescription drug list to find your medicine's drug tier. Please note, some drugs may be covered by your plan's medical benefits.

  • Medical benefits: drugs covered by medical benefits must be given to you by a health care professional in a health care setting.
  • Pharmacy benefits: drugs covered by pharmacy benefits are prescribed medicines you can take on your own.

Taking a drug not on your list? Log in to your member account to search prescription drugs.

 
Pharmacist smiling at a patient.

COSTOS DE MEDICAMENTOS CON RECETA

Cómo funcionan los niveles de medicamentos recetados 

You'll pay the cost of your prescription until you meet your plan's annual deductible. Then, you'll pay an out-of-pocket amount depending on your drug's tier. Cuando le receten un medicamento, puede buscar el nivel de pago de cobertura para medicamentos en su lista de medicamentos.  It will also show you if your drug has any additional requirements.

Some plans have 4 tiers and others have up to 6 tiers. Cada nivel tiene su propio costo. Typically, the lower a tier, the lower the cost of the prescription.

Farmacias de la red

Save Money With In-Network Pharmacies

When you pick up your prescriptions from a pharamacy that's in your network, you may save money. 

 

Ahorro en medicamentos con receta

Ways to Save Money on Your Prescriptions

Prescriptions can be expensive. You may be able to save on your drug or pharmacy costs. As always, check with your doctor or pharmacist to learn if these options may work for you.

Prescriptions and a BCBSMT ID card icon.

Use in-network pharmacies.

Your out-of-pocket costs are often lower when you get your prescriptions from an in-network pharmacy. 

Ícono de documento

Keep your prescriptions updated.

Speak with your doctor about submitting an authorization request. Or, if your drug has an additional requirement or is no longer covered, ask to change your prescription.

Two prescription pills icon

Get MedsYourWay® discounts.

MedsYourWay automatically applies drug discount card prices on eligible prescriptions. Just show your member ID card at an in-network pharmacy to learn if you could save.

Ícono de médico

Ask about lower-cost options.

You may have lower-cost alternatives for your prescription, like generic drugs. Speak with your doctor about your options.

Scissors cutting a dollar bill icon.

Visit a value pharmacy.

Value pharmacies often have the highest savings. You can also fill up to a 90-day supply of most covered drugs in these stores or through home delivery.

Pill bottle icon

Opt for a 90-day supply.

Some prescriptions can be filled in a larger amount, just like you would buy in bulk from a grocery store. Depending on your medicine, you might be able to save time with a 90-day supply.

 

Additional Requirements

Do You Have More Steps to Get Your Prescription?

1 La cobertura se basa en los términos y límites de su compañía aseguradora. Para algunos medicamentos, debe cumplir con ciertos criterios antes de que se apruebe la cobertura de medicamentos con receta.

2 Drugs that have not received U.S. Food and Drug Administration approval are not covered. Es posible que algunas coberturas incluyan beneficios de medicamentos preventivos. Esto significa que puede pagar un costo menor, de hasta $0, por los medicamentos de atención médica preventiva. Si su cobertura tiene beneficios de medicamentos preventivos, y la cobertura de su medicamento recetado cambia, es posible que también cambie el monto que usted paga por el beneficio de medicamentos preventivos. Es posible que algunos medicamentos estén incluidos en su cobertura médica y no en sus beneficios farmacéuticos.

3 You can use a drug manufacturer’s coupon or copay card to help lower your prescription cost at check-out. The amount of that coupon or copay card used to pay for a covered prescription drug will not apply to your plan deductible or out-of-pocket maximum (unless it is a permitted third-party cost sharing payment).

4 Los precios de la red Value Pharmacy no están disponibles para las coberturas con 100% de gastos compartidos.

5 MedsYourWay is not insurance. Se trata de un programa de tarjeta de descuento de medicamentos que compara el precio de la tarjeta de descuento de un medicamento elegible en las farmacias participantes con el monto de gastos compartidos de la cobertura del asegurado y luego aplica el precio más bajo disponible. Los medicamentos elegibles están sujetos a cambios, los precios de los medicamentos con receta pueden variar según la ubicación y no todas las farmacias son participantes. MedsYourWay es administrado por Prime Therapeutics, LLC, una compañía aparte que ofrece soluciones farmacéuticas para su cobertura.

6 No todos los medicamentos recetados se pueden surtir con suministros para 90 días y es posible que deban surtirse en determinadas farmacias o mediante entrega a domicilio. En función de los beneficios de su cobertura, es posible que no ahorre en gastos de bolsillo, pero sí podrá ahorrar tiempo al no tener que acudir a la farmacia.