Pharmacy Benefits

Blue Cross Complete of Michigan members are eligible for pharmacy benefits. You can use your benefits to fill prescription and over-the-counter medicines at a pharmacy in our network.

Finding a pharmacy

You can find a list of pharmacies near you on our Find a Pharmacy page. You can also see a copy of our pharmacy network by clicking here: Printable Pharmacy Network (PDF). If you’d like a hard copy mailed to you, call Pharmacy Customer Service at 1-888-288-3231. TTY users should call 1-888-988-0071.

More information about your pharmacy benefits can be found in your handbook (PDF).

Using your ID card for prescriptions

Show your member ID card to your pharmacy. This will help you get your prescription coverage.

Prescriptions

Your doctor may prescribe medicines when you need them. We cover medicines that are:

  • Prescribed by a licensed health care professional
  • Medically necessary
  • Approved by the Food and Drug Administration
  • Not excluded by the Michigan Medicaid program

Changes to Medicaid prescription coverage effective October 1, 2019

To help ensure all Medicaid patients receive quality care, all doctors who treat Medicaid patients are required to enroll with the Michigan Department of Health and Human Services. Beginning October 1, 2019, Medicaid can no longer pay for prescriptions if doctors aren’t enrolled with MDHHS CHAMPS.

If you can’t get your prescriptions after October 1, call Blue Cross Complete’s Pharmacy Customer Service at 1-888-288-3231 to talk to us about your options. We’re available from 8:30 a.m. to 6 p.m., Monday through Friday. TTY users should call 1-888-988-0071.

Opioid safety and resources

Opioids are a class of drugs that include pain medicines available from a doctor. Drugs, such as morphine, codeine and oxycodone are common opioids used to treat pain. Others include the synthetic opioid, fentanyl, and the illegal drug, heroin. If misused or not taken as prescribed, all opioids are able to cause addiction or death.

If you are prescribed opioids
Work with your doctor to make a plan for your treatment and discuss the risks of taking opioids. If possible, a nonopioid treatment may be used. Take your medicines exactly as prescribed — never in larger or more frequent doses. Store your opioids in a safe, secure place that isn’t accessible to children, family or visitors. If you have unused medicine, dispose of it properly by requesting a medicine disposal bag from Blue Cross Complete, or finding a collection site near your home.

When opioids become a problem
Opioid use disorder happens when someone becomes dependent on a drug and it interferes with his or her daily life. He or she may take too much of a prescription or turn to an illegal alternative. It can happen to anyone. If you or someone you know needs help, call the Substance Abuse Hotline at 1-800-662-HELP (4357). You can also explore resources and other materials on the Michigan Opioid Resources webpage or through MI Blues Perspective.

If you or a loved one are at risk of an opioid overdose, you may want to carry naloxone, a medication that can reverse an overdose. You can get naloxone from a registered pharmacy without a prescription. MDHHS has a map of pharmacies approved to provide naloxone.

If you can’t get naloxone locally, you can ask to have it mailed to you. To qualify, you’ll be asked to watch a training video, answer a quiz and provide enrollment information. Visit NEXT Naloxone to learn more.

If you suspect someone is overdosing, call 911 immediately.

If you need to talk to a loved one about their opioid use
MDHHS has resources for approaching a loved one whose behavior indicates they may be using opioids. The information includes a helpful guide about talking to your loved one with healing language.

Medicine disposal bags available for members

Do you have old or unused medicine lying around? It’s important to get rid of it safely. Blue Cross Complete can help you do that. We provide free medicine disposal bags to members. You can use these bags to get rid of your old medicine. It’s good for the environment and protects your household from any misuse.

To request medicine disposal bags: 

  1. Visit the Contact Us page.
  2. Once there, click on the Secure Email Form.
  3. Fill out the form.
  4. For the subject box, select Member-Medicine Disposal Bags as your topic. Choose the quantity of bags you'd like to order.

It may take up to 10 business days for you to receive your order. If you have questions, call Customer Service at 1-800-228-8554, 24 hours a day, seven days a week. TTY users should call 1-888-987-5832.

National Prescription Drug Take Back Day

National Prescription Drug Take Back Days occur in October and April each year. These events provide a safe and easy way to get rid of medicines you no longer need. To find disposal locations near you, use this helpful search tool.

For more information, visit takebackday.dea.gov.

Over-the-counter medicines and products

We cover some over-the-counter medicines and products. You must have a prescription from your doctor. Some medicines we cover are:

  • Sinus and allergy medicines
  • Medicines to help you quit smoking
  • Pain medicine, such as acetaminophen, naproxen and ibuprofen
  • Heartburn medicine, including antacids and famotidine

See the Preferred Drug List (PDF) for the full list of covered over-the-counter medicines.

See the Preferred Diabetes Monitoring Supplies (PDF) for the full list of covered blood sugar monitors and supplies.

See the Preferred Insulin Syringes and Pen Needles (PDF) for the full list of covered insulin syringes and pen needles.

Carve-out medicines

Some medicines are covered by the state of Michigan and not by Blue Cross Complete. These medicines are called “carve-outs.” The carve-out list (PDF) includes medicines used for HIV, hepatitis C, cystic fibrosis, seizure disorders, sleep problems and some behavioral health issues. The pharmacy will need your MIHealth card or your Medicaid ID number to process carve-outs.

Members 21 and older will pay a small fee for carve-outs. The copay is $1 for generic medicines and $3 for brand-name medicines.

Copays

We cover the medicines on our Preferred Drug List (PDF). You won't have a copay for these medicines. Always show your member ID card at the pharmacy.

Note: Healthy Michigan Plan members won’t have a copay at the pharmacy. They may have a charge on their MI Health account.