BCBSTX Improves Pharmacy Mail Service Program

Blue Cross and Blue Shield of Texas is committed to finding ways to deliver greater value to our

customers. With this goal in mind, we are pleased to announce that we have secured improved

pricing with PrimeMail, our contracting mail service pharmacy. Pending regulatory approval, the new

pricing will be implemented this month.

By using the same maximum allowable cost (MAC) reimbursement methodology for generic drugs

that is used for the retail pharmacy network, thus eliminating any pricing discrepancies between retail

and mail service and making mail service an even better value for our customers. MAC pricing

establishes a maximum reimbursement amount for a generic medication regardless of the

manufacturer.

The change to MAC pricing “at mail” will improve overall discounts on generic drugs by an average of

9 percent and reduce total mail-service costs by approximately 5 percent. While the vast majority of

members will pay less out-of-pocket as a result of this change, some members’ prescriptions may be

more expensive. Letters will be sent to those members who may experience an increase in out-ofpocket

expense under this new arrangement.

Later in 2009 we will be implementing changes to our mail-service reimbursement rates for brand

medications, which will provide enhanced discounts for our customers based on account size.

It is ALWAYS a good idea to ask the pharmacist if the actual cost of the drug is less than the co-pay!