Select your medical plan provider below to access your pharmacy benefit information.
Prescription Drug Coverage for BCBSTX Plan Members
Pharmacy Plan Information
If you are enrolled in a Michaels BCBSTX medical plan, your pharmacy benefit is administered by Prime Therapeutics.
- You and your covered family members have access to $0 preventative maintenance medications – with no deductibles – when prescriptions are filled from the preventative drug list.
- Prime Therapeutics uses a drug formulary, which is a list of preferred medications available at a lower cost to you. Learn more by visiting MyPrime.com.
- When your doctor prescribes medication, you’re encouraged to confirm it’s on the formulary list. If not, ask your doctor if a comparable medication on the formulary will work for you.
- Depending on the medical plan, you may also use your pretax account funds, like a Health Savings Account or Healthcare Spending Account, to help pay for your prescription expenses.
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Maintenance Medications
Maintenance medications are prescriptions that you need on a regular basis for an ongoing condition, such as high blood pressure. Maintenance medications on the preventive drug list are available for $0 copay with no deductible.
When starting a maintenance medication, ask your doctor to write the prescription for a 90-day supply instead of a 30-day supply.
You may fill an initial 30-day supply of a maintenance medications at a retail pharmacy. After that, ongoing prescriptions must be filled as a 90-day supply at a 90-day retail pharmacy or through home delivery:
- 90-day Retail Pharmacy: Over 55,000 participating pharmacies which include CVS, Wal-Mart, Kroger, etc. Check out MyPrime Pharmacies to find a location near you.
- Home Delivery: It can take up to two weeks for you to receive your medication using this method. If you need medication immediately, ask your doctor for a 30-day prescription at a local pharmacy.
Medications may take up to 5 business days or more to deliver after order verification.
- For BCBSTX plan members: Your doctor may be able to upload your prescription directly to the prescription drug provider. Otherwise, you must complete a Home Delivery Service Form in the BCBSTX member portal and send in your written prescription.
Specialty Drugs
Specialty drugs are prescribed to treat complex and/or chronic conditions, such as multiple sclerosis, cancer, hepatitis C and rheumatoid arthritis. These drugs often have special handling or storage needs and may only be filled at select pharmacies. It is also vital to closely follow the drug care plan from your health care provider or pharmacist.
Michaels offers Advocate+ Pharmacy Match for all specialty medications. This new program aims to make your health care journey easier. This specialty drug program matches you to the best-fit pharmacy to fill your specialty drug prescription. A dedicated customer service team will be by your side throughout your care plan.
Your Advocate+ Pharmacy Match Care Specialist will make sure you get the care you need by:
- Connecting you with the pharmacy that will be filling your specialty drug(s).
- Offering one-on-one support for a smooth process with the first prescription fill and beyond. Answering any questions and providing resources to help pay for your drug(s).
- Assisting with prior authorization submissions, if needed.
Get Started
To speak to an Advocate+ Pharmacy Match Care Specialist, call 833-950-3858, Monday through Friday, 8 a.m. to 10 p.m. ET.
Split-Fill Program for Select Specialty Drugs
If you receive a new prescription for certain specialty drugs, you may try a smaller quantity of the drug before the full supply is filled. This may help cut down on waste of unused medications by making sure the newly prescribed medication works for you.
If you receive a new prescription for certain specialty drugs, you may try a smaller quantity of the drug before the full supply is filled. This may help cut down on waste of unused medications by making sure the newly prescribed medication works for you.
Drug Lists
- Performance Select Biosimilar Drug List Formulary (includes Dispensing Limits, Prior Authorization Programs, and Step Therapy Programs)
- Preventative Drug List (Preventative Drug Benefit Program)
- Contraceptive List (ACA)
- Drug List (ACA)
- Specialty Drug List
Helpful Resources
Prescription Drug Coverage for Imagine360 Plan Members
Pharmacy Plan Information
If you are enrolled in a Michaels Imagine360 medical plan, your pharmacy benefit is administered by Prime Therapeutics.
- You and your covered family members have access to $0 preventative maintenance medications – with no deductibles – when prescriptions are filled from the preventative drug list.
- Prime Therapeutics uses a drug formulary, which is a list of preferred medications available at a lower cost to you. Learn more by visiting MyPrime.com.
- When your doctor prescribes medication, you’re encouraged to confirm it’s on the formulary list. If not, ask your doctor if a comparable medication on the formulary will work for you.
- Depending on the medical plan, you may also use your pretax account funds, like a Health Savings Account or Healthcare Spending Account, to help pay for your prescription expenses.
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Maintenance Medications
Maintenance medications are prescriptions that you need on a regular basis for an ongoing condition, such as high blood pressure. Maintenance medications on the preventive drug list are available for $0 copay with no deductible.
When starting a maintenance medication, ask your doctor to write the prescription for a 90-day supply instead of a 30-day supply.
You may fill an initial 30-day supply of a maintenance medications at a retail pharmacy. After that, ongoing prescriptions must be filled as a 90-day supply at a 90-day retail pharmacy or through home delivery:
- 90-day Retail Pharmacy: Over 55,000 participating pharmacies which include CVS, Wal-Mart, Kroger, etc. Check out MyPrime Pharmacies to find a location near you.
- Home Delivery: It can take up to two weeks for you to receive your medication using this method. If you need medication immediately, ask your doctor for a 30-day prescription at a local pharmacy.
Medications may take up to 5 business days or more to deliver after order verification.
- For BCBSTX plan members: Your doctor may be able to upload your prescription directly to the prescription drug provider. Otherwise, you must complete a Home Delivery Service Form in the BCBSTX member portal and send in your written prescription.
Specialty Drugs
Specialty drugs are prescribed to treat complex and/or chronic conditions, such as multiple sclerosis, cancer, hepatitis C and rheumatoid arthritis. These drugs often have special handling or storage needs and may only be filled at select pharmacies. It is also vital to closely follow the drug care plan from your health care provider or pharmacist.
Michaels offers Advocate+ Pharmacy Match for all specialty medications. This new program aims to make your health care journey easier. This specialty drug program matches you to the best-fit pharmacy to fill your specialty drug prescription. A dedicated customer service team will be by your side throughout your care plan.
Your Advocate+ Pharmacy Match Care Specialist will make sure you get the care you need by:
- Connecting you with the pharmacy that will be filling your specialty drug(s).
- Offering one-on-one support for a smooth process with the first prescription fill and beyond. Answering any questions and providing resources to help pay for your drug(s).
- Assisting with prior authorization submissions, if needed.
Get Started
To speak to an Advocate+ Pharmacy Match Care Specialist, call 833-950-3858, Monday through Friday, 8 a.m. to 10 p.m. ET.
Split-Fill Program for Select Specialty Drugs
If you receive a new prescription for certain specialty drugs, you may try a smaller quantity of the drug before the full supply is filled. This may help cut down on waste of unused medications by making sure the newly prescribed medication works for you.
If you receive a new prescription for certain specialty drugs, you may try a smaller quantity of the drug before the full supply is filled. This may help cut down on waste of unused medications by making sure the newly prescribed medication works for you.
Drug Lists
- Performance Select Biosimilar Drug List Formulary (includes Dispensing Limits, Prior Authorization Programs, and Step Therapy Programs)
- Preventative Drug List (Preventative Drug Benefit Program)
- Contraceptive List (ACA)
- Drug List (ACA)
- Specialty Drug List
Prescription Drug Coverage for Kaiser Plan Members
If you’re enrolled in the Michaels Kaiser HRA plan, you must fill your prescriptions at a Kaiser-associated pharmacy in order for them to be covered. You can use your HRA to pay for prescription drugs.