Pharmacy Benefits

Prescription Drug Benefit

BMC HealthNet Plan is committed to providing quality and affordable medications for our Massachusetts members through our prescription drug benefit.

Some of the great features of our prescription drug benefit include:

• Coverage of thousands of medications as listed on the BMC HealthNet Plan Formulary.
• Affordable copayments for generic medications for all members.
• Choice of over 1000 chain and independent retail pharmacies throughout Massachusetts where members can get prescriptions filled.
• Special services and medications for members with rare or chronic health conditions through our specialty pharmacies.
• Members can also obtain a three-month supply of certain prescription medications mailed to their homes from our mail order pharmacy.

Over-the-Counter Drug Benefit (MassHealth and Commonwealth Care Members)

BMC HealthNet OTC Formulary is a list of all products that are covered under the over-the-counter benefit. In general, only the generic versions or store brands of the listed products are covered, all other OTC products are excluded from the benefit. All products listed on the OTC Formulary have a Tier 1 copayment except diabetic testing supplies which are covered without a copayment. A prescription is required for an over-the-counter product to be covered. Over-the-counter drugs are only available at participating retail pharmacies and may not be obtained through the mail order pharmacy.