UNM Hospitals

4-Tier Prescription Drug Plan

UNMH Standard and Extended Options include prescription drug coverage for generic, brand-name, and specialty medications.

Your copayment for prescription drugs is based on whether the drug you receive is a generic or a brand-name drug AND whether the drug is on the BCBSNM Drug List. See your Benefit Booklet or Summary for details, limitations, and exclusions.

Type of Prescription  Copay Level  Retail Pharmacy
30-day supply – You pay:
 
Mail-Order
90-day supply – You pay:
 
Generic drugs Tier 1 $10 $20
Brand-name drugs Tier 2 $35 $70
Brand-name drugs not on Drug List Tier 3 $60 $120
Specialty drugs* Tier 4 N/A* N/A*

*Specialty medications require prior authorization; these drugs cannot be obtained through the PrimeMail Pharmacy Program, our prescription drug mail-order service. Specialty medications must be acquired through a participating specialty pharmacy in order to be covered; for a 30-day supply you will pay $250 or 20%, whichever is less.

Learn more about BCBSNM prescription drug benefits and the Specialty Pharmacy Program.

Log in to Blue Access® for Members to access your secure Prime Therapeutics account to order prescriptions online via the PrimeMail prescription mail-order service, view your prescription history, research medications, locate pharmacies, and more.

If you have any questions about your prescription drug benefits, call Customer Service at the toll-free number on the back of your BCBSNM member ID card.

 

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