Blue Cross Blue Shield of Illinois announces improved prescription mail-service pricing

Jan 21, 2009 | Blue Cross Blue Shield, Blue Cross Blue Shield of Illinois, Insurance News | 0 comments

Blue Cross Blue Shield of Illinois announced improved pricing with PrimeMail, their contracting mail service pharmacy. Pending regulatory approval, they begin implementing this pricing for non-HMO business in February 2009.

The new pricing will use the same maximum allowable cost (MAC) reimbursement methodology for generic drugs that is used for the retail pharmacy network, thus eliminating any pricing discrepancies between retail and mail service and making mail service an even better value for our customers. The use of MAC pricing establishes a maximum reimbursement amount for a generic medication regardless of the manufacturer.

The change to MAC pricing at mail will improve overall discounts on generic drugs by an average of 9 percent and reduce total mail-service costs by approximately 5 percent. While the vast majority of members will pay less out-of-pocket as a result of this change, some members’ prescriptions may be more expensive. Letters will be sent to those members who may experience an increase in out-of-pocket expense under this new arrangement.

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