Call us for more information about BCBSTX CHIP Rx drug benefits.
Prescription Drug Coverage
As a Blue Cross and Blue Shield of Texas CHIP plan member, you have pharmacy benefits. The benefits for the Texas CHIP program are determined by the Medicaid/CHIP Vendor Drug Program (VDP) and are administered by BCBSTX. This means select generic and brand-name prescription drugs, medical supplies and over-the-counter (OTC) drugs are covered.
This plan goes by a list of preferred drugs. The Drug List (also called a formulary) is a list showing the drugs and medical supplies that can be covered by the plan.
- – Download a machine-readable version of the VDP Drug List that is in accordance with CMS regulations and guidance.
As a CHIP member, your copayments will be listed on your ID card for the items on the Drug List. Those items will be covered as long as you:
- have a medical need for them
- have a prescription from your doctor for them
- fill the prescription at a network pharmacy
- follow the plan rules
Prior Authorization
Certain drugs on the list may need a prior authorization (“PA”). Your doctor will need to request approval before these drugs can be prescribed. Without approval, the drugs are not covered. If your doctor wants you to have a drug that is not on the list, he or she can request approval for that drug. For some drugs, the plan limits the amount that will be covered. You can find out if your drug has any added conditions or limits by looking at the Drug List.
Here are ways your doctor may submit a PA request:
- Call 1-855-457-0407
- Fax in completed forms at 1-877-243-6930.
To protect your health and keep you safe, make sure your doctor and pharmacist know all the medicines you are taking, including OTC drugs.
Note: BCBSTX does not cover cannabis. Cannabis comes from the cannabis plant. It has delta-9-tetrahydrocannabinol (THC) as an active ingredient. Cannabis may be called marijuana. BCBSTX does not cover cannabis in any form. This includes:
- Plant seeds
- Extracted resin
- Salt or other derivative
- Any mixture or preparation of cannabis-derived compounds
Find a Pharmacy
As a member, you have access to a wide network of pharmacies in Texas.
By Phone
We are available 24 hours a day, 7 days a week. The call is free. Members with hearing or speech loss can call the TTY/TDD line at 711.
Home Delivery (Mail-Order Service)
Are there medicines that you take regularly or long-term? Regular medicines are taken sometimes more than once a day or many times a week. These drugs can also be taken long-term, for more than 3 months. They may treat chronic conditions like high cholesterol, high blood pressure, asthma or depression and anxiety. You can order the drugs that you take long-term or every day through the Walgreens Mail Service and have them delivered to your home.
This home delivery service offers:
- Up to a 90-day supply of your regular or long-term medicine mailed at one time
- Three ways to order refills: online, by phone or through the mail
- A choice to get a text or email notice to let you know when they have received your order, and to let you know when your prescription has been mailed
Walgreens Mail Service
Download Rx Forms
The following prescription drug forms are PDF files. Have your doctor complete and submit these forms.
Prior Authorization (PA) Forms
Have your doctor . They can also fax in completed forms at 1-877-243-6930. Or your doctor can call 1-855-457-0407.
Other Prescription Drug Forms
If you or your provider have questions about these forms, call the Customer Advocate Department at 1-888-657-6061 (TTY: 711).
Frequently Asked Questions
Check the FAQs to learn more about your Rx benefits.
Contact Us
Need Help?
Members
Call 1-888-657-6061Providers
Call 1-877-560-8055* Please note: This is a large file. It may take longer to download. Internet speed, browser and computer hardware may impact your download time.
Prime Therapeutics LLC is a separate company contracted by Blue Cross and Blue Shield of Texas to provide pharmacy solutions. Blue Cross and Blue Shield of Texas, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics LLC. MyPrime.com is a pharmacy benefit website offered by Prime Therapeutics LLC.