Bulletins

Blue KC transitions to new pharmacy benefits manager

Reminder: Blue KC to transition to new pharmacy benefit manager

Authored by Bukaty Companies on November 21, 2019

Some members will experience a network change

Starting January 1, 2020, OptumRx will be the pharmacy benefit manager (PBM) for Blue Cross Blue Shield of Kansas City (Blue KC) members. Express Scripts, the current PBM, will provide pharmacy services through December 31, 2019.

Network changes
Some members will experience a pharmacy network change. Those affected will receive a letter with options for new in-network pharmacies. There will be no pharmacy network listed on the member ID cards. Members can find their pharmacy network names on benefit summaries and SBCs. Members can visit BlueKC.com/pharmacy to find more in-network pharmacies.

As a guide, the current pharmacy networks and corresponding 2020 network names are listed below.

CURRENT PHARMACY NETWORKS (EXPRESS SCRIPTS) MEMBERS WITH THIS NETWORK 2020 PHARMACY NETWORKS (OPTUMRX)
NATIONAL PLUS  2 – 99 groups  RxPremier
TIERED EXPRESS ADVANTAGE WITH NATIONAL PLUS WRAP 100-plus groups  Tiered RxPreferred with RxPremier wrap
WALGREENS ADVANTAGE  Groups with any of six ACA plans  RxSelect


New member ID cards

Most members should receive new ID cards in December 2019 for January 1, 2020 use. Digital versions are available January 1, 2020 by logging into MyBlueKC.com. New member ID cards will not list copays or the member’s new pharmacy network. There will also be a clear description of the behavioral health and substance use service with contact information listed.

Home delivery
For continued home delivery, members must update payment information and set up an account with OptumRx. Certain controlled substances and prescriptions that have expired will require a renewed prescription from the member’s doctor.

Specialty pharmacy
Members taking specialty drugs will receive instructions on how to begin utilizing OptumRx Specialty Pharmacy in early November. This notice will also include available benefits of the specialty pharmacy.

For questions, contact your Bukaty benefits consultant at 913.345.0440.

Blog Category: Carrier Notice