Blue Cross and Blue Shield prescription plan change affects some CVS customers


CULLMAN – Last year, Blue Cross and Blue Shield of Alabama (BCBSAL) and its pharmacy benefits management entity Prime Therapeutics (PT) dropped CVS pharmacies from certain insurance plans, effective Jan. 1.  CVS was careful to point out that this was not their decision, and that they would prefer to have remained in the plan. 

Upon removing the nation's largest pharmacy chain (9,000+ stores nationwide, 180+ in Alabama) from these plans, PT named no. 2 chain Walgreens as its new "core provider" for the affected plans.  This comes as no surprise to insurance industry observers, as PT and Walgreens formed what they termed a "strategic alliance" last August.

According to the official announcement on Walgreens' website, the change is a cost-saving move.  According to Prime CEO Jim DuCharme, "With costs rising at unsustainable rates, we must take strong and decisive action to make healthcare more affordable.  We’re trying to apply the brakes to this run-away freight train of rising drug costs by aligning the cost control expertise of the trusted Blue + Prime model with Walgreens supply chain capabilities and sending a message that we are on board with finding a solution to this issue."

So how do you know if you've been affected?  If you have, you probably already know: BCBSAL sent out notifications back in November to those affected.

Who is affected?  BCBSAL clients who purchased their plans under the Affordable Care Act, also known as Obamacare, and those covered under certain small business plans are the only groups who will have to change pharmacies.  This is not an inconsequential number: approximately 390,000 customers statewide; but it does represent only about 13 percent of the company's clients.  Those covered under other BCBSAL plans are not affected.

CVS is still included in drug plans for those covered under commercial group plans and those secured through an employer, as well as those covered under BCBSAL Medicare Part D.

For those who have been affected, other options are available.  Some local pharmacies have even begun reaching out in advertisements.  Area Walgreens stores are an obvious option, but many others also remain covered.  Listed as Prime participants on the BCBSAL website are more than 20 other Cullman County drug stores:

  1. Hospital Discount Pharmacy           
  2. Borden Family Pharmacy
  3. Rite Aid Pharmacies                       
  4. Grande Pointe
  5. Healthmart Pharmacy
  6. Hoppers Family Pharmacy              
  7. Cullman Internal Medicine Pharmacy
  8. CRMC                                              
  9. Ed Holcombe Discount Pharmacy
  10. Cullman Discount Pharmacy           
  11. Medical Arts Apothecary
  12. Specialty Pharmacy                         
  13. Village Discount Drugs
  14. Publix                                              
  15. Econo Medical
  16. Wal-Mart                                            
  17. Express Meds
  18. McSwain's Pharmacy                       
  19. Good Hope Pharmacy
  20. Heritage Pharmacy                          
  21. Blue and Gray Drugs
  22. Hanceville Drugs                             
  23. Lakeside Pharmacy
  24. Murphy's Pharmacy                         
  25. West Point Family Pharmacy

These listings are per the BCBSAL website, and have not been individually verified.  Those needing a change in prescription provider should contact pharmacies directly for information.


Copyright 2017 Humble Roots, LLC. All Rights Reserved.