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Missouri Plan Benefits

With Blue Preferred®, you get more of what you want – more choices, more convenience and more control. That’s a lot of more. And with Anthem, you get a dedicated, dependable partner to join you on your journey.

Learn more about the Blue Preferred POS High Option

Let’s break down some details of the High Option, Blue Preferred Plus Point-of-Service (POS) plan.

  • You can visit network or non-network providers
  • Know before you go: Those non-network providers are going to cost a little more out-of-pocket for you
  • When you see network providers, there’s no deductible . . . you’ll have lower out-of-pocket, too

View a List of Plan Providers


 

Pharmacy Benefits for Blue Preferred® High Option

Prescription Drug Copays for 2021

This table shows your monthly and yearly costs for prescription drugs in 2021. If you have any questions about your coverage, call the Member Services number on the back of your identification card.

Level 1

30-Day Supply (Retail) Yearly Cost 30-Day Supply (Retail) 90-day Supply (Mail Order) Yearly Cost 90-Day Supply (Mail Order)
Tier 1 $5 copay $60.00 $10 copay $40.00
Tier 2 $60 copay $720.00 $150 copay $600.00
Tier 3 $80 copay $960.00 $200 copay $800.00
Tier 4 25% of our allowance
($250 maximum per prescription)
90-day supply is not available 90-day supply is not available
Prescription Drug Copays for 2021 at Level Two - Blue Preferred Plus POS High Option

Level 2

30-Day Supply (Retail) Yearly Cost 30-Day Supply (Retail) 90-day Supply (Mail Order) Yearly Cost 90-Day Supply (Mail Order)
Tier 1 $15 copay $180.00 N/A N/A
Tier 2 $70 copay $840.00 N/A N/A
Tier 3 $90 copay $1,080.00 N/A N/A
Tier 4 25% of our allowance
($250 maximum per prescription)
90-day supply is not available 90-day supply is not available

Level 1

Level 2



Learn more about the Blue Preferred POS High Option

Let’s break down some details for the Standard Option, Blue Preferred Health Maintenance Organization (HMO) plan.

  • You have to stay in network with this plan
  • No referrals required for network providers
  • No annual deductible

View a List of Plan Providers


 

Pharmacy Benefits for Blue Preferred® Standard Option

Prescription Drug Copays for 2021

This table shows your monthly and yearly costs for prescription drugs in 2021. If you have any questions about your coverage, call the Member Services number on the back of your identification card.

Level 1

30-Day Supply (Retail) Yearly Cost 30-Day Supply (Retail) 90-day Supply (Mail Order) Yearly Cost 90-Day Supply (Mail Order)
Tier 1 $10 copay $120.00 $20 copay $80.00
Tier 2 $70 copay $840.00 $175 copay $700.00
Tier 3 $90 copay $1,080.00 $225 copay $900.00
Tier 4 25% of our allowance
($250 maximum per prescription)
90-day supply is not available 90-day supply is not available
Prescription Drug Copays for 2021 at Level Two - Blue Preferred HMO Standard Option

Level 2

30-Day Supply (Retail) Yearly Cost 30-Day Supply (Retail) 90-day Supply (Mail Order) Yearly Cost 90-Day Supply (Mail Order)
Tier 1 $20 copay $240.00 N/A N/A
Tier 2 $80 copay $960.00 N/A N/A
Tier 3 $100 copay $1,200.00 N/A N/A
Tier 4 25% of our allowance
($250 maximum per prescription)
90-day supply is not available 90-day supply is not available

Level 1

Level 2



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