Your Prescription Drug Plans
If you enroll in the City of Chattanooga medical plans, you automatically receive prescription drug coverage administered by BlueCross BlueShield of Tennessee (BCBST).
If you enroll in the PPO plan, your plan features copays for prescription drugs. You have three choices of where to purchase prescriptions: the WellAdvantage pharmacy, retail pharmacies or through home delivery. Your copays are listed in the table below.
*If you enroll in the HDHP plan with HSA, then all your pharmacy charges will apply towards your deductible. Then, you will pay 20% of the cost of the prescription (the plan pays 80%) until you meet your out-of-pocket maximum amount.
Because of the rising cost of prescription drugs and because so many frequently prescribed medications are available over-the-counter (OTC), your pharmacy benefit plan does not cover prescription drugs that have an OTC alternative. This may help you to buy the medications you need, when you need them without having to get a prescription from your physician. Check your Evidence of Coverage (EOC) or call Customer Service at the number listed on your BCBST ID card for more information on your plan's coverage for medications that have OTC alternatives.
Over the Counter Alternatives
While there are several classes of medications available OTC, some of the most popular are widely prescribed classes are:
Allergy treatment drugs, such as non-sedating anti-histamines (known as NSAs)
Stomach disorder drugs, such as HS blockers and proton pump inhibitors (known as H2s + PPIs)
Talk with your doctor to see which OTC products might work for you. You can continue to take prescription products if you choose, but you will be responsible for paying the full cost of the drug.
If your doctor has a medical reason for you to take a PPI prescription medication rather than an OTC alternative, he or she should send a fax to Medco for prior authorization at 1-888-343-4232. If Medco does not authorize the prescription, you will be responsible for 100% of the drug cost.