Prescription Drug Plan

Administered by Prime Therapeutics

Prescription drug benefits are part of SMU's BCBSTX BlueChoice© PPO medical plans, but are administered by Prime Therapeutics. You have the choice of purchasing your prescriptions through local retail pharmacies or through a mail order program. Please click on the tabs above to access additional information.

IMPORTANT: Be sure to log into myprime.com and register so that you have access to find in-network pharmacies, price medications, get forms, and keep track of your prescription medications. Registration is easy:

    Resources

    Mail Order (90-Day Supply)

    Administered by Walgreens Mail Service

    (877) 357-7463

    www.walgreens.com/primemail

    Important:  Prime Therapeutics PrimeMail recently combined with Walgreens Mail Service. Your PrimeMail prescription(s) will now be filled by Walgreens Mail Service.  The mail service phone number (877-357-7463), Customer Service hours of operation (24/7) and refill reminders will not change.

    You will now see the new name on your pill bottle(s) and pharmacy benefits communications.  When it's time to refill a prescription, it will be refilled by Walgreens Mail Service.  If you don't have refills, or if your prescription expires, ask your doctor to fax a new prescription to Walgreens Mail Service at 1-800-332-9581.

    The PrimeMail mail order prescription program should be used for prescription medications that you take on a regular basis (maintenance medication). You may order up to a 90-day supply of your medications and they will be mailed directly to your home, typically at reduced cost to you.

    Mail Order (90-Day Supply) You Pay

    $2,000 Deductible PPO
    You must meet a $100 deductible each year for brand name medications; then, you pay the following amounts:

    Generic 30% of cost up to $20
    Preferred Brand Name 30% of cost up to $98
    Non-Preferred Brand Name 50% of cost

    $2,800 Deductible PPO
    You pay 100% of the cost until you have met the annual plan deductible; then, you pay the following amounts:

    Generic 30% of cost up to $20
    Preferred Brand Name 30% of cost up to $98
    Non-Preferred Brand Name 50% of cost

    $5,000 Deductible PPO
    You pay 100% of the cost until you have met the annual plan deductible; then, you pay the following amounts:

    Generic 0% of cost
    Preferred Brand Name 0% of cost
    Non-Preferred Brand Name 0% of cost

    Important Notice: Specialty Drugs are covered through the Retail service and the Prime Therapeutics Specialty Pharmacy Program (dispensed by Walgreens). You will find additional information on the Specialty Pharmacy Program Tab above.

    Resources

    Retail (Up to 30-Day Supply)

    Administered by Prime Therapeutics

    www.myprime.com

    The retail prescription program utilizes a network of participating pharmacies. To receive the highest benefit level, you must use a participating pharmacy. Prescriptions filled at non-participating pharmacies are generally not covered.

    If you need to find an in-network pharmacy or price a specific medication, go to www.myprime.com and register as a new user if you have not yet registered. Click on Find Medicine or Find Pharmacy, as needed.

    Retail(30-Day Supply)

    $2,000 Deductible PPO
    You must meet a $100 deductible each year for brand name medications; then, you pay the following amounts:

    Generic 30% of cost
    Preferred Brand Name 30% of cost
    Non-Preferred Brand Name 50% of cost
    Specialty Medication 30% of cost up to $225 max per script

    $2,800 Deductible PPO
    You pay 100% of the cost until you have met the annual plan deductible; then, you pay the following amounts:

    Generic 30% of cost
    Preferred Brand Name 30% of cost
    Non-Preferred Brand Name 50% of cost
    Specialty Medication 30% of cost up to $225 max per script

    $5,000 Deductible PPO
    You pay 100% of the cost until you have met the annual plan deductible; then, you pay the following amounts:

    Generic 0% of cost
    Preferred Brand Name 0% of cost
    Non-Preferred Brand Name 0% of cost
    Specialty Medication 0% of cost

    Resources

    Specialty Pharmacy Program

    Administered by Prime Therapeutics

    (877) 627-6337

    Specialty medications are generally high-cost injectable drugs with special handling or storage requirements that require strict adherence to treatment protocols. Through the Prime Therapeutics Specialty Pharmacy Program, members using covered specialty medications can have their medication delivered directly to them, as well as receive coverage coordination and support. There is no additional fee for these services.

    To contact the Prime Therapeutics Specialty Pharmacy Program, call (877) 627-6337.

    Important Notice: Specialty Drugs are covered through the Retail service and the Prime Therapeutics Specialty Pharmacy Program (dispensed by Walgreens). You will find additional information on the Specialty Pharmacy Program Tab above.