All of the State of Iowa's health plans provide prescription drug coverage. Review the DAS-HRE health insurance websites for information on the prescription drug benefits for the different health insurance plans.
A drug formulary is a list of prescription drugs, both generic and brand name, that helps guide physicians and pharmacists in selecting the medications that provide the most appropriate treatment for the best price.
To see if a drug is covered, go to the Wellmark Drug List website and click on “BlueRx Complete” from the Choose a Drug List drop-down menu at the website.
Wellmark reviews and updates the formulary regularly to ensure that it continues to provide coverage for drugs that are cost effective and safe. Drugs on the formulary are grouped into three tires and your copayment is determined by the tier your medication is on.
Show your Wellmark ID card when you fill a prescription at a participating pharmacy to save time and money. Network pharmacists have computer access to current member information to help them identify duplicate therapies or interactions from drugs dispensed by other network pharmacies.
Mail Order Prescription
All of the State of Iowa's health insurance plans offer a mail order prescription drug benefit except Deductible 3 Plus.
The mail order drug benefit allows you to order prescriptions drugs through the mail. You can receive a 90-day supply for just the cost of two copays instead of the three copays that you would receive by ordering the prescription from a retail site.
The advantages of ordering prescription drugs through the mail are:
- Saving the cost of a copay
- Convenience of the prescription drug mailed to your home
In this example, you are enrolled in Blue Access, family coverage. You or someone in your family takes a maintenance medication. The copay for the prescription is $15 for a 30-day supply. If you refill that prescription at a retail pharmacy every month, you will spend $180 per year on that prescription ($15 copay x 12 months.)
Instead of refilling that prescription drug every month at a retail pharmacy, you decide to utilize mail order. For a 90-day supply, your copay will only be $30. That’s just two copays of $15. Because you get a 90-day supply, you will only refill the prescription approximately 4 times a year. Using mail order, you will only pay $120 per year ($30 copays x 4 times a year.) That’s a savings of $60 per year for just one prescription!
Think what your savings could be if you or your family member has more than one maintenance medication or the copay was $30 per prescription.
There is no charge for standard shipping of your prescription orders. If requested, expedited shipping is available. Standard order are shipped via U.S. Postal Service .However, UPS is used for secure next day delivery when an order contains a time sensitive, temperature-sensitive item, or an extremely high-cost item.
Information on starting to use mail order service is available at Wellmark's Mail Order Pharmacy Service website.
Vaccines at the Pharmacy
You have the convenience of going to a pharmacy to receive certain vaccines as part of your prescription drug provision of your Wellmark health insurance plan. .
The vaccines that can be administered at the pharmacy and be covered by Wellmark are:
- Diphtheria, Tetanus, Pertussis (DT&P) Measles, Mumps, Rubella (MMR)
- Haemophilus influenzae type b (Hib) Meningococcal (MPSV4)
- Hepatitis A (HepA) Pneumococcal
- Hepatitis B (HepB) Rotavirus (Rota)
- Human Papillomavirus (HPV) Varicella
- Inactivated Poliovirus (IPV) Zoster (over age 60)
For some vaccines, you may need a prescription from your doctor. Check with your pharmacy to determine if a prescription is needed.
Specialty Prescription Drugs
Specialty drugs are prescription medications that require special handling, administration or monitoring. These drugs are used to treat complex, chronic and often costly conditions, such as multiple sclerosis, rheumatoid arthritis, hepatitis C, and hemophilia.
To learn what drugs are considered specialty drugs, go to the Wellmark Drug List. Wellmark has two preferred specialty pharmacy providers: Hy-Vee Pharmacy Solutions (HPS) and CVS Caremark Specialty Pharmacy.
For more information about health insurance, please contact Wellmark customer service at 800-622-0043.
The Department of Administrative Services – Human Resources Enterprise is providing this information about the State of Iowa’s benefits. The information on this web page is subject to change. Nothing herein shall be construed as a guarantee of benefits. This webpage is not a complete description of the State of Iowa’s benefit plans. Nothing on this web page supersedes or changes any of the terms and conditions of any plan documents, insurance policies, or other legal agreements. If the wording in this web page contradicts any plan documents, laws, regulations, administrative rules, insurance policies, or other legal agreements, the wording in the official documents and agreements will govern.