Small Group Blues Enroll - Arkansas Blue Cross and Blue Shield

ARKANSAS BLUE CROSS AND BLUE SHIELDSMALL GROUP BLUESENROLL GROUP ADMINISTRATOR’S MANUALSection 4 - MANAGED DRUG PROGRAMOVERVIEWIn an effort to help hold the line on escalating prescription medication costs,Arkansas Blue Cross and Blue Shield provides a Managed Pharmacy Programthat will help maintain quality health care.The information in this section will give you an overview of the ManagedPharmacy Program and help you find answers to questions about howemployees can best utilize their benefits. Specific details about the employee’spharmacy benefits should be discussed with a Customer Service Representativeof Caremark.The Managed Pharmacy Program is designed to eliminate the need for claimforms when using a participating pharmacy. If an employee uses a nonparticipatingout-of-state pharmacy, a claim form will be necessary forreimbursement of these charges. Pharmacy claim forms are provided uponrequest.The Arkansas Blue Cross/Health Advantage Managed Pharmacy Program,administered through Caremark, contracts with more than 57,000 pharmaciesnationwide to help ensure employee have access to the medications they needwherever they go.Once a prescription is filled, the pharmacist will store the personal prescriptionhistory in a state-of-the art system to alert the pharmacist to dangerous druginteractions, allergies, sensitivities to medications, and chronic ailments. Thesequality assurance measures help to protect the employee and enhance thequality of care.BENEFITSThe Managed Pharmacy Program offers customers and their covereddependents benefits, including the following:• Cost savings• No claim forms• Nominal co-payments and/or coinsurance• Specialized customer service• Access to an extensive pharmacy networkWhen an employee presents an ID card, participating pharmacists (working withthe employee’s physician) can closely monitor medication therapy. Pharmacistswill be able to determine whether:• The medication to be dispensed may combine in a harmful way withanother medication currently prescribed.Small Group BluesEnroll R 10/25/07 12