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As a member of Blue Shield Promise Cal MediConnect Plan, you have a quarterly over-the-counter (OTC) allowance that allows you to purchase OTC products you may need.

This benefit provides you a set amount each quarter to spend on everyday health and wellness items. This benefit also offers you the convenience of delivery to your preferred address. While your plan’s OTC benefit covers items including aspirin, vitamins, cold and cough preparations, and bandages, other items such as cosmetics and food supplements are not covered. The OTC catalog lists the items we’ll cover.

Quarterly benefit allowance

To find out how much your OTC benefit covers each quarter, just check your plan’s Summary of Benefits or Member Handbook. You can place two orders per quarter and cannot roll over your unused allowance into the next quarter. Some limitations may apply. Refer to the OTC catalog for more information.

How to place an order

You have two easy ways – by phone and online – that you can place an order with OTC Health Solutions and have your OTC items delivered to your preferred address. It typically takes no more than two weeks to receive your order in the mail. If you place an order via IVR (Interactive Voice Response), there is a limit of 15 items or less. See the OTC benefits catalog below for more information. You should have your Blue Shield Promise Cal MediConnect member ID card ready when you place your order.
  Phone:(888) 628-2770 [TTY: 711], 9 a.m. – 5 p.m.,Pacific time, Monday through Friday
 www.cvs.com/otchs/bscaphp

English (PDF, 6.2 MB)

Chinese (PDF, 2.8 MB)

Korean (PDF, 2.7 MB)

Spanish (PDF, 4.2 MB)

Vietnamese (PDF, 2.7 MB)

Questions about your OTC benefit?

If you have any questions, please call OTC Health Solutions at (888) 628-2770 [TTY: 711], 9 a.m. – 5 p.m. Pacific time, Monday through Friday. Translation services are available at this number.

Durable medical equipment

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Prescription drug benefit information

Access and search your plan formulary - the list of drugs covered by your plan. Get pharmacy directories and learn about specialty pharmacies in our network and our mail service pharmacy. Review medication related policies.

Learn about the prescription drug benefits

Find a pharmacy

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Page last updated: 12/1/2021

Pharmacy and Prescription Drugs

Your Benefits Include A Wide Range Of Prescriptions And Over-The-Counter (OTC) Medicines

HIP Plus and Hoosier Care Connect members can even have their medicines delivered to their home. We work with IngenioRx to provide these pharmacy benefits.

Find A Pharmacy

Individuals who meet these eligibility factors can apply:

Find a Pharmacy

Fill A Prescription

Bring your member ID card and prescription to a plan pharmacy. Your doctor can also call in the prescription for you.

It’s good to use the same pharmacy each time you fill a prescription. This way, your pharmacist will know about problems that may happen when you’re taking more than one prescription. If you use another pharmacy, you should tell the pharmacist about all medicines you are taking.

Have Your Medicines Mailed To You

We make getting your prescriptions filled as convenient as possible. HIP Plus and Hoosier Care Connect members can log in to their account and manage prescriptions filled through home delivery. With a secure online account, you can:

• Order refills
• Track your shipments
• Get notifications

Log in to your account

Prescription Drug Home Delivery Form

You can get many prescription drugs shipped directly to your home through IngenioRx Home Delivery. Use this form to set up home delivery on your prescription.

You can reach the Care Team at 1-833-255-0646 (TTY 711), 24 hours a day, seven days a week.
 

• PMP Selection Form - English
• PMP Selection Form - Spanish

Your Costs

Copays are a set dollar amount you pay for a covered service, like getting a prescription filled.

There is no pharmacy copay for:
 

• HIP Plus members.
• ​Women in the HIP Maternity Plan.
• American Indian/Alaska Native members.
• Members who have spent 5 percent of their income for copays and/or contributions.
• Drugs given as an emergency supply.

HIP Basic Members

Preferred Drugs

$4 per prescription

Nonpreferred drugs

$8 per prescription

Hoosier Healthwise Members

There is no pharmacy copay if you’re:

• In Package A (children and pregnant women).
• In Package P (women who are presumptively-eligible).
• Getting services in the ER, hospital or nursing home.

Hoosier Healthwise members who get benefits under Package C (children under 19 years of age who don’t qualify for Package A) have a $3 copay for generic drugs and a $10 copay for brand-name drugs.

Generic Drugs

$3 copay

Brand-name drugs

$10 copay

Hoosier Care Connect Members

3 copay per script

There is no pharmacy copay if you’re:

• Under 18 years old.
• Pregnant.
• American Indian or Alaskan Native.
• Receiving services related to pregnancy or family planning.

Drug Coverage Information

Your benefits include a wide range of prescription drugs. Anthem also covers many over-the-counter (OTC) medicines with a prescription from your doctor. We have two drug lists that show which drugs are in your plan.

Searchable Formulary

The formulary is a list of all brand-name and generic drugs available in your plan. It lists all the drugs found on the PDL, plus others. All drugs on the formulary are covered, but many require preapproval before the prescription can be filled.

Find Your Medicine

Do you want to look up your medicine and find out if it is covered in your plan? It’s easy when you use our search tool. This tool will help you learn about any limitations or restrictions for any particular drug.

You can search for your drug by:

• Typing the name (at least first three letters) of the drug in the search box.
• Using the A-Z list to search by the first letter of your drug.
• Clicking on the therapeutic class of the drug.

Don’t See It Listed?

If you don’t see your medicine listed on the drug lists, you may ask for an exception at . You’ll be asked to supply a reason why it should be covered, such as an allergic reaction to a drug, etc.

Prior Authorizations (Preapprovals)

Some medicines need a preapproval, or an “OK,” from Anthem before your provider can prescribe them. The preapproval process helps us make sure that you’re taking medications safely and correctly.

Here Are Some Reasons That Preapproval May Be Needed:

• There is a generic or pharmacy alternative drug available
• A drug is listed as nonpreferred on the PDL
• The drug could be misused or abused
• There are other drugs that should be tried first
• The drug has a high side effect potential
• You’re getting more drugs than what is normally expected
• The drug is prescribed at a higher dosage than recommended
• There is additional information needed about your condition so we can match it to the FDA approval of the drug and/or studies of effectiveness

For medicines that need preapproval, your provider will need to call Provider Services. Anthem will review the request and give a decision within 24 hours. If you need your medicine right away, you may be able to get a 72-hour supply while you wait.

Need Help?

If you misplace your medicine or it is stolen, contact your provider. They will work with the pharmacy and Anthem to review your case and replace the medicines as needed.

If you have any questions about your pharmacy benefit, call Pharmacy Member Services 24 hours a day, seven days a week.

Learn more about your pharmacy benefits in your member handbook.

Pharmacy Forms

Get Your Specialty Medications

If you have a complex or chronic health condition that requires special medicine, we can help. We partner with IngenioRx Specialty Pharmacy and other pharmacies to meet all your specialty medication needs. Learn about specialty pharmacy.

Page Last Updated: 10/28/2022

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