Prescription Drug Benefits

With Blue Cross Blue Shield of Michigan and Blue Care Network pharmacy coverage, you'll give your employees an all-in-one cohesive health care experience, and you'll reduce costs.

What you'll get with our prescription drug benefits

Medical and pharmacy policies that align with each other
One centralized point of contact
The flexibility to tailor offerings based on your group’s needs
Expanded reporting for an overall view of your employees' usage

Better Rx

The right access, improved care, plan engagement and informed decisions for your organization.

A woman looks at her prescription

Improved Care

Blue Cross and Blue Care Network clinical pharmacy programs help ensure the safety, medical necessity, appropriateness and efficacy of the medicines your employees take.

Improved care
A woman types on her laptop computer

Plan Understanding and Employee Engagement

Giving your employees the tools they need to take charge of their health care is just as important for their prescription drug coverage as it is for their medical coverage.

Plan understanding
A pharmacist goes over a prescription with a person

Informed Decisions for your Organization

Integrating pharmacy and medical benefits in one Blue Cross health plan gives your business and employees holistic coverage for smarter, better health care.

Informed decisions

How it works

Pharmacy is often your employees' most-used benefit, so it's important to provide them with the best experience possible. To ensure excellence, we've focused on these key concepts to better support you and your employees.

The right access for your organization and employees

We offer a large network with more than 65,000 pharmacies nationwide and more than 2,000 pharmacies in Michigan. With an eye on the right access, our goal is to maximize savings and convenience for you and your employees.

As part of that, we support health care providers with improved pharmacy technology so patients get the most appropriate and economical medications available. We also encourage members to enroll in home delivery because it's more affordable and convenient.

Though we offer the largest network in Michigan, we're vigilant in safeguarding you and your employees' access. We're committed to protecting your health care investment and have conducted fraud investigations that recently netted $34 million in savings.

Improved care for individual needs

We promote clinically sound, cost-effective medications for positive therapeutic outcomes​. Here's how: 

Formulary management​

To understand what the most effective medications are we have joint committee reviews and extensive monitoring. We also evaluate clinical effectiveness, side effects and offer low-cost benefit options.

Utilization management​

We're continuously evaluating the medical necessity, appropriateness and efficiency of health care services and medications​ to ensure their effectiveness. We do this through programs like step therapy, prior authorization and quantity limits, which has amounted to more than $310 million in savings in 2019.

Specialty ​pharmacy care​

We provide management of medications that are either high cost, high complexity or high touch​. This helps reduce your costs and improve your employees' health.

Medication adherence

Medication adherence can have a positive impact on the quality and length of your employees' lives. We encourage our pharmacy members to take their medications as prescribed. This is communicated through automated text and email reminders for prescription refills, consolidated pharmacy fills and coupons and copay assistance.

Plan understanding and engagement

All our programs work to lower costs and improve care, but they only work if your employees can find and use them with ease. We ensure your employees use and see the value in the benefits you provide them. 

In fact, we've raised the bar on the member experience by providing personalized, proactive guidance the entire year to educate, enable and influence member actions. 

With our member-first approach, you can be sure that your employees can use their pharmacy benefits in an easy, useful and personal manner.

Informed decisions for your organization

We understand your employees need help getting the right care, but we also understand that you look to us for insights and guidance. 

Our team of account managers, group customer advocates, data analysts, consultants and utilization and payment integrity professionals are at your service. We all work together to anticipate your needs and intervene on your behalf. 

As a team, we're committed to meet and exceed your organization's health care needs.

We're Ready to Help

Contact your sales representative or agent today to learn more about Prescription Drug Benefits.

Learn more about prescription drug coverage

  • Learn about your pharmacy benefits (PDF)
  • Pharmacy overview placemat (PDF)
  • Customer pricing flyer (PDF)
  • Pharmacy shared rebates flyer for groups with 25-49 employees (PDF)
  • Pharmacy shared rebates flyer for groups with 50-999 employees (PDF)
  • Pharmacy shared rebates flyer for groups with 1,000+ employees (PDF)
  • Diabetes management products flyer (PDF)
  • Prior authorization and step therapy (PDF)
  • Drug adherence discount program (PDF)
  • High-cost drug discount optimization program for fully-insured groups (PDF)
  • High-cost drug discount optimization program for self-funded groups (PDF)

Prescription drug news

Read the latest news and information involving prescription drugs.

MI Blues Perspectives
Two women look up benefits online
News Release

Blue Cross Blue Shield of Michigan partners with OptumRx for pharmacy benefit management services

Our new partnership with OptumRx will provide prescription drug benefit services designed to improve the pharmacy experience, drive better health outcomes and lower costs.

Read the release
Pharmacists discuss a drug together

Better benefits: Give employees discounts on medications

Our Drug Adherence Discount Program helps employers facilitate better medication adherence and lowers prescription costs for their employees.

Find out more
A doctor visits with a mother and child

Increase the impact of your Blue Cross medical benefits by adding pharmacy

When you bundle your medical and pharmacy coverage with Blue Cross Blue Shield of Michigan, you can do more for your employees and your business.

Read the article

Explore health care insights

Read about the latest news and innovations from the experts themselves.

See all insights
A woman holds her baby while looking at her plan

Blue Cross Master Class

Join a live presentation with our health care experts, examining topics you've told us mean the most to your business.

Reserve your seat
A woman looks over her benefits on her smartphone

Pharmacy benefit manager changes

We're moving to a pharmacy benefits management system to keep costs more stable for our group customers and members.

Read more about the changes
An employer prints out documents for their employees

Resources to share with your employees

Browse brochures, videos and posters designed to help your employees get the most out of their Blue Cross coverage.

View toolkits

Still have questions?

We can help you find the right solutions for your business' unique needs.