Understanding Your Pharmacy Benefits

Every Blue Advantage plan includes generous Part D prescription drug coverage to help with the costs of your medications. Below is an overview to help you better understand your coverage and how to get started using your benefits.

Medicare Part A and Part B Coverage

It is important to remember that enrollment in Blue Advantage does not affect Medicare coverage for any drugs that may be covered under Medicare Part A or Part B. If you meet Medicare's coverage requirements, your drugs will still be covered under Medicare Part A or Part B even though you are enrolled in Blue Advantage. See the Medicare & You Handbook for more information about the drugs that are covered by Medicare Part A and Part B.

Important Note: Blue Advantage members automatically receive their Medicare Part D prescription drug coverage. If you join another Medicare plan, including a Medicare prescription drug plan, you will be disenrolled from our plan when your enrollment in the new plan begins.

Understand Helpful Terms

Do you need help understanding the difference between your deductible and copay? Or generic drugs and tiers? Use this list of common terms to help you understand your coverage and benefits.

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Find & Price Your Prescription Drugs

Do you want to get an idea of your annual drug costs based on your current prescriptions? You can find a network pharmacy, search for covered drugs and estimate your annual drug costs by using our Find & Price Prescription Drugs tool below!

Find & Price Prescription Drugs

Understand Your Part D Explanation of Benefits

We will send you an Explanation of Benefits (EOB) for each month when you use your benefits or if we need to notify you of a change in coverage for a drug you are currently taking. Your EOB will include how much you have paid so far this year for your prescriptions as well as any recent claims. Please Note: Items/services appear on the EOB when a claim is processed, not necessarily for the month in which you received the item or service.

Want to go paperless? By registering with Express Scripts, you have the option to receive your Part D EOB statements online rather than by mail.

You can also:

  • Get up to 18 months of EOB statements. Your Medicare Part D EOBs are stored securely online, so you can view, print or download them whenever you need them.
  • Quickly view summaries of drug claims processed since your last EOB and see your total out-of-pocket and drug costs.
  • Easily find information about your benefit stage, including how close you are to the Coverage Gap.
  • View any updates to the list of covered drugs that could affect your medications.

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Now that you understand more about your pharmacy benefits, you're on the right path to maintaining and improving your health. Become a pro by learning how to view the formulary and understand utilization management, save time and money getting your prescriptions drugs, and learn more about our prescription support programs!

View the Formulary & Utilization Management

View the formulary to know which drugs are covered by the plan and which may require utilization management, such as prior authorizations.

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Getting Your Prescription Drugs

As a Blue Advantage member, you can use these money and time-saving tools like a three-month supply to make getting your prescriptions even easier!

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Prescription Support Programs

We know that taking your drugs as your doctor orders can mean better health outcomes for you. That's why we offer you support to help you stay on track.

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Special note: Some Blue Advantage (HMO) Group Medicare Advantage plans do not offer preferred cost-sharing when you use a preferred pharmacy. You can still use a preferred pharmacy but may not pay less for your prescriptions than you would at a standard network pharmacy. If you are a Blue Advantage (HMO) – Group Medicare Advantage member, read your plan's Benefit Documents to see if this applies to you.

Express Scripts is an independent company that serves as the pharmacy benefit manager for Blue Cross and Blue Shield of Louisiana and Blue Cross and Blue Shield of Louisiana HMO.

We're always happy to help!

Just a Phone Call Away

Reach out to us for help or any questions you may have about your health care coverage and plan benefits.

Call us at: 1-866-508-7145 (TTY 711). Our phone lines are open 8 a.m. to 8 p.m., 7 days a week from October - March and 8 a.m. to 8 p.m., Monday - Friday from April - September

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