Consumer Option Prescription Drug Coverage
Under the Consumer Option, participants pay the costs of prescription drugs in full until meeting the deductible. After meeting the deductible, the plan pays 80% of the costs (in-network). There are two ways for you to receive your prescription drugs—through retail pharmacies or through Prime Therapeutics PrimeMail®, a home-delivery pharmacy service.
Retail Drug Service
You can have your prescriptions filled at a participating pharmacy (most national chains and most local and independent pharmacies) and receive up to a 30-day supply of your prescription. You will pay the Prime Therapeutics negotiated rate.
If the pharmacist does not submit (or is unable to submit) a claim on your behalf, you can submit your claim using the NC Prescription Reimbursement Claim Form. For example, you may use this form if you paid the full cost for prescriptions because the system did not reflect your coverage when you purchased the medications. You may also use this form if you have other medical coverage in addition to your BB&T coverage, and this other insurance is primary. In this case, you can complete the form to submit a claim for prescription drug costs not covered by your primary insurance.
You can save time and money by having prescriptions filled through the Prime Therapeutics PrimeMail home-delivery pharmacy service. To fill prescriptions through PrimeMail, follow the steps in one of the options below:
- Go to BlueConnectNC.com.
- Under Member Login, enter your user ID and password
- Choose Prescriptions (site will open Prime Therapeutics' site in a new window)
- Choose on Transition Prescriptions from Retail to PrimeMail and follow the directions
- You or your doctor call 855-457-0220.
- If you call, please have your prescription name and strength ready, as well as your doctor's name and phone number.
- Ask your doctor to fax a prescription to 877-774-6360 or submit through ePrescibe.
- Send a request by mail.
- Ask your doctor for a 90-day prescription that PrimeMail will fill. If you need this medicine immediately, ask for a second 30-day prescription you can fill immediately at your local pharmacy.
- Fill out the PrimeMail order form and mail the prescription, order form and payment to: PrimeMail, PO Box 650041, Dallas TX, 75265-0041. Please include a method of payment to avoid any delays in processing your order.