Pharmacy Benefits

BCBSMT offers many of our members drug coverage benefits.  Express Scripts, Inc. (ESI) is the independent company chosen by BCBSMT to manage its pharmacy benefit.   Contact Express Scripts, Inc. by calling 1.800.567.1970 or visiting  ESI.

NEW! Express Scripts Claims Status
BCBSMT and ESI are pleased to offer our registered members secure online access to ESI claim information.  Log in as a Member from our Home Page and select My Pharmacy in the links area located above your eligibility information.  This link will route you directly to ESI.  If you are not a registered member, visit our Home Page for instructions.  Registration is easy and will give you access to your BCBSMT and ESI information.    
 
Submitting Claims
Members are encouraged to have their claims processed electronically at their pharmacy to ensure the best price.  However, if the pharmacy is unable to process electronically or you forgot your ID card, you can submit your claim to ESI using the following form:

Express Scripts Member Reimbursement form PDF 91kb  

Preferred Medications (Formulary)
BCBSMT uses a custom list of preferred and non-preferred medications called a formulary.  The formulary is reviewed and maintained by a group of physicians and pharmacists.  Members and providers can select the appropriate link below to access the most current version of the formulary:

2008 Member Formulary PDF 34kb
2008 Physician Formulary PDF 203kb  

Or,  you may access the ESI website and type in the name of the drug you wish to search for:  Express Scripts Formulary. 

Prior Authorization
Some medications require a prior authorization before they can be utilized.  Furthermore, some employer groups may have customized prior authorization lists that differ from BCBSMT's standard list.  These lists are not meant to take the place of your contract and members are encouraged to refer to their contract for additional information.  The following link provides information regarding medications that require prior authorization as well as employer groups who have customized prior authorization lists: 

Drugs & Drug Classes Requiring Prior-Authorization PDF 31kb  

Specialty Pharmacy
CuraScript, Inc., an independent company of ESI, provides specialty pharmacy services (generally self injected medications) on behalf of ESI, BCBSMT's pharmacy benefit manager.  Members may obtain their first fill at a local pharmacy, but refills must be processed by CuraScript.  Insulin products and Lovenox (enoxaparin) are exempt from this refill requirement.

CuraScript can be reached at 1.800.824.9223, or by visiting:  www.curascript.com.

Participating Pharmacy Network
ESI contracts with at least 50,000 pharmacies nationwide to ensure that our members have access to a participating pharmacy. 

To find the participating pharmacy closest to you, use the link below:

Montana Pharmacy Network PDF 122kb   

Mail Order Pharmacy Services
Ridgeway Pharmacy, located in Victor, MT, provides mail order prescriptions to our members.  Depending on your pharmacy benefit, using mail order services can provide more medication at a reduced cost.  Use the link below to take advantage of this opportunity:

Ridgeway Pharmacy mail order form PDF 61kb.

Visit the Ridgeway Pharmacy website for more information:  www.ridgewayrx.com.