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Blue Cross Blue Shield of Michigan
New Pharmacy Programs
We're now offering your patients who are our members another opportunity to reduce their out-of-pocket prescription drug expenses and still receive the effective, high-quality medical care they count on.
Preferred Therapy
This program encourages the use of the most cost effective drugs over the higher priced brand-name medications if a prescription for the targeted brand-name medication has not been filled in the last six months (180 days).
Generic Copayment Holiday
This program offers a copay wavier for three retail or three mail order prescriptions when members switch to the generic equivalent of a specifically targeted drug.
Off-Label / High-Cost Specialty Review Program
This program disallows coverage for drugs prescribed for uses other than those approved by the FDA and requires a prior authorization review of other high cost specialty drugs.
Dose Optimization
We'll encourage the use of specific prescription drugs in once-daily dosage regimens, as opposed to using lower multiple doses of the same drug.
Brand-to-Generic Interchange
This program calls for single-source brand-name drugs to be interchanged with less costly generic alternatives. Though some targeted medicines do not have a generic equivalent of their own, similar prescription drugs with a generic counterpart are available, thus creating the interchange.
Quantity Limit for Selected Drugs
We'll block the dispensing of targeted drugs in quantities that are inconsistent with their labeling.
Generic Copay Waiver Program
We'll waive the first copay for a preferred generic drug when a member switches to the generic from the brand-name medication.
Questions? We can help!
To verify a member's benefit plan or get answers to your pharmacy-related questions, please contact us.
