Pharmacy
 
 

Mail Order Pharmacy Benefit

BMC HealthNet Plan members may choose to have maintenance drugs sent to their homes instead of filling prescriptions at a local retail pharmacy. Maintenance drugs are those drugs that are refilled regularly for conditions like diabetes, asthma and high blood pressure. Members may enroll with informedMail® Order pharmacy to begin receiving drugs in the mail. Once enrolled, members may refill prescriptions by mail, phone, or online.

Save time and money with mail order
There are many features to the mail order pharmacy benefit:

  • Members save time and effort by not making extra trips to the pharmacy each month.
  • Members will also save money when choosing to receive generic (Tier 1) or preferred brand name (Tier 2) drugs.

Available Drugs
Only maintenance prescription drugs can be obtained through the BMC HealthNet Plan mail order program. The following drugs can not be obtained through the mail order:

  • Controlled substances
  • Over-the- Counter (OTC) drugs
  • Drugs requiring pre-authorization
  • Drugs requiring step therapy
  • Drugs with quantity limitations
  • Biotech or specialty drugs

If you are unsure if your drug falls into one of the above categories, please call informedMail® at (800) 881-1966 to verify if your medication is available through the mail order benefit.

Mail Order Copayments
Members can only obtain a three-month supply of their maintenance drug through the mail. The chart below shows the copayments members will pay when ordering drugs through the mail:

Mail Order Copayments
(Three-month supply)

MassHealth & Commonwealth Care Plan Type I Members

Commonwealth Care Plan Type II & III Members
      Plan II Plan III
Select generic drugs $1* Generic drugs $20 $25
All other generic and brand-name drugs $3 Preferred drugs $40 $50
    Non-Preferred drugs $120 $150
* Copayments for covered generic and over-the-counter drugs (with a prescription) will be $3 EXCEPT for certain covered generic drugs that members may take for high blood pressure, high cholesterol or diabetes. The copayment for these will be $1. Please call one of the numbers below to find out your copay if you don’t know.

Copayment exemptions that apply to the retail pharmacy also apply to mail order pharmacy.

Benefit Enrollment
Follow the instructions below to enroll with informedMail® pharmacy:

  • Step 1: Have your doctor write your prescription for the number of days your plan allows for mail order service (for example, 90 days supply). By law, informedMail® can only fill the quantity indicated by your doctor.

    Note: If you need your medicine right away, ask your doctor to write two prescriptions. The first one you can fill right away at your local drug store. The second one you can mail to informedMail®.
  • Step 2: Fill out the Enrollment/Order Form and Confidential Patient Profile below. Write down information for you and any family members ordering prescriptions. You only need to fill out this form for your first order.
  • Step 3: Write the member identification number and patient’s name on the back of each prescription.
  • Step 4: Mail the signed Enrollment Form, along with the written prescription(s), and check, money order or credit card information for all required copayments to the address below:
  • Step 5: We will send orders to the address you put on form.

informedMail®
P.O. Box 407096
Ft. Lauderdale, Fl 33340-7096

Medications will be shipped for free using standard delivery services. Overnight or two-day shipping is also available for a fee.

For more information on the mail order benefit:

  • Call informedMail® at (800) 881-1966.
  • Visit our Web site, www.informedrx.com to place your refill order. Or:
  • BMC HealthNet Plan’s Services Call Center at (877) 957-5300.
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