Starting Oct. 1, 2024, coverage of abiraterone acetate will change for many of our commercial members with pharmacy benefits administered by Prime Therapeutics. These members will only have coverage for the CivicaScript ® -produced, low-cost generic version of abiraterone acetate 250 mg. This drug is only available through SortPak Pharmacy.
Zytiga and other generic versions of abiraterone acetate 250 mg will no longer be covered on the drug lists for our members with employer group or individual health plan benefits.
Send prescriptions to SortPak
Letters about this change will be sent to members with claims for Zytiga or other generic versions of abiraterone acetate 250 mg. The letter explains how to receive the medication from SortPak, including where to send the prescription.
If your patient receives this letter and asks for a new prescription, please e-prescribe or fax:
Why the change?
Our partnership with CivicaScript furthers our initiatives to make prescription drugs more affordable for our members. Lower cost generic drugs help lower members’ out-of-pocket costs and improve medication adherence.
Check eligibility and benefits
Treatment decisions are between you and your patients. Coverage is subject to the terms and limits of your patients’ benefit plans. Always check eligibility and benefits for each member at every visit. This step confirms membership and other details, such as prior authorization requirements and utilization management vendors, if applicable.
If your patients have questions about pharmacy benefits, they can call the number on the back of their member ID card, log in to Blue Access for Members SM or visit MyPrime.com .
Trademarks are the property of their respective owners.
The information mentioned here is for informational purposes only and is not a substitute for the independent medical judgment of a physician. Physicians are to exercise their own medical judgment. Pharmacy benefits and limits are subject to the terms set forth in the member’s certificate of coverage which may vary from the limits set forth above. The listing of any drug or classification of drugs is not a guarantee of benefits. Members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions.
Checking eligibility and/or benefit information and/or obtaining prior authorization is not a guarantee of payment. Benefits will be determined once a claim is received and will be based upon, among other things, the member’s eligibility and the terms of the member’s certificate of coverage, including, but not limited to, exclusions and limitations applicable on the date services were rendered. Regardless of benefits, the final decision about any medication is between the member and their health care provider. If you have any questions, call the number on the member's ID card.
Blue Cross and Blue Shield of Montana contracts with Prime Therapeutics to provide pharmacy benefit management and related other services. BCBSMT, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics.
CivicaScript is an independent company that supports BCBSMT to offer prescription cost-saving options. CivicaScript is independent from and not affiliated with BCBSMT.
SortPak Pharmacy is an independent pharmacy that contracts with CivicaScript to provide mail order prescription drug services. SortPak Pharmacy is independent from and not affiliated with BCBSMT.
BCBSMT makes no endorsement, representations or warranties regarding third party vendors and the products or services they offer.