Blue Cross and Blue Shield of North Carolina (BCBSNC) recently changed its pharmacy benefit manager (PBM) for its commercial membership. As of April 1, BCBSNC commercial members now have their prescription benefits managed by Prime Therapeutics. Please note: this does NOT affect State Health Plan members. Pharmacy coverage has not changed for Plan members, therefore, they will continue to have their prescriptions filled through Medco and their participating pharmacies.

BCBSNC commercial members received new member ID cards indicating the change in the PBM to use when visiting the pharmacy to pick up a prescription. This has caused some confusion at the pharmacy when a State Health Plan member is getting a prescription filled. The pharmacy incorrectly assumes that the Plan member ID card is incorrect and will not fill the prescription. State Health Plan members do not have new ID cards and should continue to use their current card.

Medco and Prime Therapeutics have both notified their network of pharmacies that Plan members still have their pharmacy benefits managed through Medco. However, there have been some reports that this information may not have reached the level of pharmacists actually filling our members' prescriptions.

If any of your employees report that they have not been able to get a prescription filled due to a change in pharmacy benefit managers, assure them the change by BCBSNC to Prime Therapeutics only applies to BCBSNC's commercial group and individual business. Members should inform their pharmacist that coverage for State Health Plan members has not changed and instruct them to fill their prescription using their current card.

If there is still a question, the member may contact Medco customer service at 800-336-5933, and a representative will contact the pharmacist in question so the prescription can be filled as ordered.