Anyone who is entitled to Medicare Part A and/or enrolled in Medicare Part B and who lives in South Carolina is eligible to join our plans, regardless of income and resources, pre-existing conditions, or current prescription drug expenses. Our service area is the state of South Carolina. You must continue to pay your Medicare Part B premium.

BlueCross BlueShield of South Carolina has formed a network of pharmacies that you must use to receive BlueCross Rx Plus plan benefits. In general, you must use network pharmacies to access your prescription drug benefit, except in special circumstances. The pharmacy network may change at any time. You will receive notice when necessary.

For an up-to-date list of the pharmacies in our network, see our Pharmacy Directory, or search by location using the Pharmacy Locator (this link leads you to a secure third-party website). You may also request that a printed pharmacy directory be mailed to you by calling Customer Service at 1-888-645-6025.

You can compare BlueCross Rx Plus to other plans using our Summary of Benefits. Please note the Summary of Benefits doesn’t list every service that we cover or list every limitation or exclusion.

To get a complete list of our benefits, please review the Plus Annual Notice of Changes or Value Annual Notice of Changes & the Plus Evidence of Coverage or Value Evidence of Coverage.  

You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for getting Extra Help, call:

• 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/seven days a week.
• The Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call 1-800-325-0778.
• Your State Medicaid Office.

BlueCross Rx uses a prescription drug list (formulary). The formulary may change at any time. You will receive notice when necessary.

For the most current information, see our Comprehensive Rx Plus Formulary, Rx Value Formulary or Rx Essential Formulary (list of covered prescription drugs) or our Drug Search Tool (this link leads to a third-party website).

Restrictions may apply. For a list of upcoming changes, see the Formulary Change Notice.

Some covered drugs may have additional requirements or limits on coverage. These requirements and limits may include Prior Authorization, Quantity Limits, or Step Therapy. Links to our plan’s Prior Authorization and Step Therapy criteria are below.

• Prior Authorization: Requires you or your physician to get prior authorization for certain drugs. This means you will need to get approval before you fill your prescriptions. If you don’t get approval, the plan may not cover the drug.
• Quantity Limits: For certain drugs, the plan limits the amount of the drug that will be covered.
• Step Therapy: In some cases, the plan requires you to first try certain drugs to treat your medical condition before another drug will be covered for that condition.