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Understanding your pharmacy benefits Welcome to Regence! Whether you want to know if a medication’s covered under your plan or are looking for ways to save on prescriptions, we’re here to help you find the information you need. To ensure you’re getting an effective drug at an affordable price, we review some medications before we cover them. Drugs on the pre-authorization list include many for which equal or more effective and lower-cost options exist. If your drug requires pre-authorization, you’ll want to do one of two things: When it comes to choosing medications, it’s important to know how a drug formulary—also called a covered-drug list or prescription drug list— works. A formulary is a list of pre-approved drugs that your Regence health plan helps cover. So when you fill your prescription, you don’t have to pay full price. The Regence formulary divides medications into multiple tiers, each with its own cost-share. Before we add a medication to the list, our team of doctors and pharmacists carefully evaluates how safe and effective it is while assessing whether it will improve health. Formularies are organized into tiers. Lower tiers typically represent a lower copay, and higher tiers typically have a higher copay. You may have a specialty tier on your covered drug list. Sign in to your Regence account to check your benefits. Is your medication covered? Pre-authorization requirements Sign in to your Regence account.* Select Covered services. Click on the Pharmacy tab. Choose Find a drug under Check costs and coverage. *Don’t have an account? Create one or use our shop module to compare plan offerings. Sign in to see if your medication’s covered, how much it’ll cost and more, including pharmacies in your network, forms, home delivery registration, specialty pharmacy information and pre-authorization policies. Talk with your doctor to see if there’s an alternative treatment that does not require pre-authorization. Have your doctor or pharmacist request pre-authorization for your medication. You may need to get that authorization before you can get your prescription filled. OR Low Tier(s) Medications that provide the highest overall value. Lower tier(s) mostly include generics but may include some brand medications. Mid Tier(s) Medications that provide moderate overall value. Mid tier(s) mostly include brand medications that are categorized based on how well they work and/or their cost compared to others that treat the same condition. Highest Tier(s) Medications that provide lower overall value. Highest tier(s) mostly include brand medications that are categorized based on how well they work and/or their cost compared to others that treat the same condition. OREGON ---PAGE BREAK--- Regence has lots of ways to help you save money on your medications, including lower-cost network pharmacies, online cost-comparison tools and convenient fill options. Network pharmacies Medication prices can vary among pharmacies. To save money, it’s best to get your prescriptions filled at a pharmacy in your network. Sign in to your Regence account to find one. Generics Generic and brand-name medications have the same strength, quality and purity. But generics can cost up to 80% less. So, ask your doctor if there’s a generic drug that will work for you. Specialty medications We know that living with a complex health condition can be stressful and sometimes confusing. Our specialty pharmacy services are here to support you with the care and medications you need, every step of the way. In some cases, your plan may require that you use our specialty pharmacy. To assist you with the complexities of your condition and its treatment, our specialty pharmacy services team will help you coordinate refills, monitor side effects and give you 24-hour access to clinical specialists. You’ll even get injectable supplies for free—and everything can be delivered to your home or location of your choice. Convenience with Amazon Home Delivery Trade the trips to your pharmacy for convenient home delivery. When you use mail order, your medications are delivered to a location of your choice with free standard shipping. There are three ways to get your medications mailed: 1. Go to amazon.com/regenceORMYW and click Get started. 2. Call an agent at 1-[PHONE REDACTED]. 3. Ask your doctor to send a prescription to Amazon Home Delivery. 90-day supplies Your benefit may cover 90-day fills. If your plan includes 90-day fills, ask your doctor to write your prescription for up to a 90-day supply, and make sure you get it filled at an in-network pharmacy for the most savings. That means fewer trips to the pharmacy. Blood glucose meter program If you have diabetes, you’re eligible to receive a new LifeScan OneTouch glucose meter at no cost. Order your meter directly from LifeScan by calling 1-[PHONE REDACTED]. Amazon is a separate company that provides home delivery pharmacy services. Questions? Call the Customer Service number on your member ID card. We’re open 24 hours a day, seven days a week. How to fill your prescription Whether you have a new prescription or need to refill an existing one, our network of more than 65,000 participating pharmacies has you covered—across the country and around your corner. Show your member ID card to your pharmacist so they can file your claim with us online and tell you how much you owe. Ways to save Regence BlueCross BlueShield of Oregon is an Independent Licensee of the Blue Cross and Blue Shield Association Regence BlueCross BlueShield of Oregon 200 SW Market Street, 11th Floor I Portland, OR 97201 REG-OR-1205384-24/08-Amazon © 2024 Regence BlueCross BlueShield of Oregon Regence complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-[PHONE REDACTED] (TTY: 711). 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-[PHONE REDACTED] (TTY: 711). JENNIFER SAMPLE JENNIFER SAMPLE Share these numbers with your pharmacist. Helpful hint: When filling a prescription, share only the numeric part of your ID number. JENNIFER SAMPLE JENNIFER SAMPLE