The UISelect pharmacy plan (BlueRx Value Plus) has a three-tiered prescription benefit. This means you will pay coinsurance for each prescription, which will vary depending on the drug's tier (or category).

Is your drug covered?

UISelect uses "BlueRx Value Plus" formulary list.

To review specific Wellmark formulary drug lists:

1. Visit the Wellmark Prescription and Drug Lists webpage. 
2. Scroll down and choose the BlueRx Value Plus link under "View your formulary drug list."  
3. You will receive a pop-up box stating, "You are now leaving Wellmark.com." Select the "Continue to new site" button.
4. You should now be on the Wellmark Drug Search webpage. You can enter the name of the drug or locate the name of the drug in the alphabetical list below the search bar in the upper lefthand corner of the webpage. 

Note: Formulary Drug Lists are best viewed in Chrome.

• This plan does not cover drugs available as over-the-counter medicines without a prescription.
• Participating pharmacies are responsible for submitting your prescription claims electronically.

Pharmacy Out-of-Pocket Maximum (OPM)

The prescription drug out-of-pocket maximum (OPM) is separate from the medical OPM. Once you reach the prescription drug OPM, the plan pays 100% of covered prescription drug expenses for the remainder of the calendar year.

Prescription Drug OPM Comparison

You are responsible for paying prescription drug coinsurance until you reach the applicable OPM amount for your coverage level.

Brand-Name Drugs and Generic Alternatives

If you purchase a brand-name drug when an FDA-approved “A”-rated generic equivalent is available, you are responsible for your coinsurance, plus any difference between the billed charge for the brand-name drug and the billed charge for the generic. This can result in you paying substantially higher costs than if you had chosen the generic drug.

If your physician feels it is essential for you to have the brand-name drug, they can prescribe it with “Dispense as written” on the prescription. In this situation, you will not be responsible for the difference between the billed charge for the brand-name drug and the billed charge for the generic drug.

There are instructions on the Wellmark website on how to Request a Waiver of Brand if necessary. 

Prescription Drug Limitations

Certain drugs are limited per month, benefit period, and lifetime by drug-specific quantity limitations, step therapy requirements, or prior authorization. Wellmark determines the limitations based on medical necessity. Visit the Wellmark website or check with your pharmacist or physician for a list of drugs subject to limitations.