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Download the latest version to access the site. 0000010006 00000 n (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. This website works best with Internet Explorer 7 and above or Firefox 2.0 and above. Rx group number and pharmacy logo -This will be on the ID card whenever a Highmark prescription drug program is included. Providers. Reporting Fraud. Sign in to the appropriate website below to complete your request. Our phone number is on your member ID card. 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. 0000017131 00000 n Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. The prescription drugs on this list are selected by a team of doctors and pharmacists and are updated on an on-going basis. 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. Weight Loss Medication Request Form. 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. 0000001566 00000 n 0000001704 00000 n That list will vary depending on the plan you choose. 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). Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties . You will use your new card for both medical and prescription benefits except for Global Core and Medicare-coordinating plans. Specialty Drug Request Form. 0000013562 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 Call 1-800-996-9969 or visit Delaware ASSIST to enroll. This program may not be applicable to all members. Select Language ; Select Language; Font size dropdown. Last updated on 10/24/2022 10:44:11 AM. Your maintenancemedications are delivered right to your door about 5-7 days after your prescription is received and delivery is free.2, As part of the Affordable Care Act, most members have access to more than 350 preventive medications at a $0 cost-share.3, Pay $10 or less for a 90-day prescription of more than 400 generic medications through Express Scripts home-delivery pharmacy.4. Highmark Blue Cross Blue Shield serves the 29 counties of western Pennsylvania and 13 counties of northeastern Pennsylvania. Each of these companies is an independent licensee of the Blue Cross Blue Shield Association. Questions on or after January 1, 2022:. Not subject to a deductible. Highmark Health Insurance Company is a PDP plan with a Medicare contract. We will retain the information in our system in accordance with applicable law and our Data Protection Policy:https://www.highmark.com/hmk2/gdpr.shtml. 2. Your ID cards will come from our medical and dental vendors (i.e., Highmark Blue Cross Blue Shield and Cigna). This information will be used for purposes of performing services to, or on behalf of, our enterprise customers and prospective customers as part of and in relation to matters regarding our provider, health plan, and subsidiary enterprise care delivery, administration and operations. Highmark Blue Cross Blue Shield Delaware serves the state of Delaware. Convenient payment options. 0000053581 00000 n 0000003884 00000 n 0000015345 00000 n Advantages of Using the Home Delivery ServiceMembers may prefer to use the home delivery prescription service. W[=v@!&mbu+ XN_ [O>&A!X*&h}r~/P$"l~[GQvw4q6,J. A member can verify his or her particular drug coverage by calling Member Service at the telephone number shown on the member's ID card or by visiting Highmark's Medicare-Approved formulary site at: http://highmark.medicare-approvedformularies.com. Forgot username or password? Need Help? 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. 0000006499 00000 n Transplant Rejection Prophylaxis Medications. Highmark Health Insurance Company is a PDP plan with a Medicare contract. Phone: 1 -800 677 3086. Additionally, Accredo has specialized pharmacists who know and understand your conditions. To view the Highmark Select/Choice Formulary, click here. The member can have one of the prescriptions filled at a local pharmacy to begin taking the medication immediately. Even when you're not sick, we'll help with your wellness goals. 8:00 a.m. to 5:00 p.m. EST. If you are not satisfied with our data processing you have the right to lodge a complaint to the data protection authority in your country of residence. 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. 0000006767 00000 n Advantages of Using the Mail Order . 0000082377 00000 n Please consult your plan documents for details or call customer service. Networks and drug benefits may vary slightly, depending upon the member's group and/or managed care program. The drug formulary is divided into sections based on the member's plan benefit design. For those members, the MedcoHealth logo appears on the member's ID card. Short-Acting Opioid Prior Authorization Form. 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. Vyleesi Prior Authorization Form. All FreedomBlue coverage includes at least the same services as those provided by Medicare. 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. Licensed Product Name 2. Most prescription drugs are covered when provided or authorized by the PCP on an outpatient basis and obtained at a Premier contracting pharmacy. Pharmacies have point-of-sale technology that confirms a member's eligibility, benefit design and copayment information at the time of dispensing. Please consult your plan documents for details. The Highmark Medicare-Approved Prescription Drug Formulary is a list of all covered Part D drugs. Managed care members must use one of the participating pharmacies in Highmark's Premier Pharmacy networks. For anything else, call 1-800-241-5704. Members may consult their pharmacy directory, visit Highmark's web site at www.highmarkblueshield.com, or call Member Services at the number shown on their ID cards to find a network pharmacy that is conveniently located. These services providers are located in the United States. FIND A DOCTOR OR PHARMACY. Providers in need of assistance should contact provider services at 800-241-5704 (toll-free). 0000018991 00000 n Medical and Rx Claims Processing Information 5. %PDF-1.3 % Refill requests online, by mail, or by phone anytime, day or night. . 0000008578 00000 n The member must still pay applicable copayments. Other Coverage for Pharmacy BenefitsSome members of SelectBlue and PPO Blue may have other prescription drug coverage that is not administered by Highmark. Highmark Blue Cross Blue Shield West Virginia serves the state of West Virginia plus Washington County. Pharmacy Benefits for FreedomBlue MembersCopayments and coverage limitations vary depending on the region, group, and/or direct-pay enrollment. DISCOVER. Home delivery service is an option that groups may select depending on their benefit design. The A prescription drug list or formulary shows which drugs are covered by each insurance plan. For those members, the Express Scripts logo appears on the member's ID card. Do not use this mailing address or form for provider inquiries. 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). 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. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. Eliminates the need to travel to a pharmacy. 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. 0000015322 00000 n After that, all Personal Data will be deleted or the documents with such data will be anonymized. Drugs are listed by brand and generic names. A prescription is required for these drugs and the member must obtain the medication through the pharmacy for coverage to apply. Highmark is not responsible for lost or stolen cards. (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. 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. To view the Highmark Medicare-Approved Select/Choice Formulary for Medicare Advantage or BlueRx members, click here. To obtain a copy of the formulary, contact your Provider Relations representative. Highmark administers prescription benefits for almost all members. 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 . Home page. These services providers are located in the United States. 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. Exclusions Apply. 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. Highmark Blue Shield serves the 21 counties of central Pennsylvania and also provides services in conjunction with a separate health plan in southeastern Pennsylvania. 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. We want to clarify these ID card changes for you so you can best . 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. 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. 0000008906 00000 n 1. You now have one card for both your medical and prescription benefits. Got a Question? 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. Up to a 90-day supply of each covered medication (compare to a typical retail 30-day supply) Online refill reminders. For those members, the MedcoHealth logo appears on the member's ID card. 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