This convenient option allows your pharmacist to submit your claim directly to Pacific Blue Cross on your behalf, as opposed to you having to pay for the medication and wait for reimbursement.
Eligible claims are subject to plan limits, including a dispensing fee cap, mark-up limits, and annual deductible and co-insurance as applicable. You only pay for the portion not covered by your plan.
And by using your pay direct benefit, your pharmacist can immediately advise you of plan restrictions, such as prior authorization, generic pricing, and day supply limits. Skipping this step may prove costly; all or a portion of your prescription may not be covered by your plan, leaving you unexpectedly out of pocket.
Your card must be enabled for pay-direct claims.