May 1, 2024

Pharmacy Carve Out Plans

As a reminder, you should always review member benefits and eligibility on bcbsri.com provider portal. When logged into your bcbsri.com account, select “Patient Eligibility”, and enter the member’s necessary information (member ID, last name, first name, DOB). 

Once the member’s information generates you will be able to see if the member’s Pharmacy’s benefits are carved out or not. The Pharmacy Benefits tab will only be available to members who have Pharmacy Benefits with BCBSRI. If there is not Pharmacy Benefits tab, the members plan has agreed to Carve Out Pharmacy Benefits. You will need to consult with the member and ask for their RX card to review who their pharmacy benefits are with. 

 Member benefit portal screenshots