Common use of Non-Participating Pharmacy Clause in Contracts

Non-Participating Pharmacy. you must pay for the prescription in full and then submit a claim form for reimbursement. Blue Shield will reimburse you as shown on the Summary of Benefits, based on the price you paid for the Drugs. See the Claims section under Your payment information for more information. Obtaining outpatient prescription Drugs from the mail service pharmacy You have an option to receive prescription Drugs from the mail service pharmacy when you take maintenance Drugs for an ongoing condition. This allows you to receive up to a 90-day supply of the Drug, which may save you money. You may enroll in this program online, by phone, or by mail. Once enrolled, please allow up to 14 days to receive the Drug. If your Physician or Health Care Provider submits a prescription for less than a 90-day supply, the mail service pharmacy will only dispense the amount prescribed. Specialty Drugs are not available from the mail service pharmacy. You must pay the applicable mail service prescription Drug Copayment or Coinsurance for each prescription Drug. Visit xxxxxxxxxxxx.xxx or use the Blue Shield mobile app for additional information about how to get prescription Drugs from the mail service pharmacy.