Dear Valued Provider,

On October 26, 2016, generic Benicar (olmesartan) and Benicar HCT (olmesartan/HCTZ) will become available to the market. Olmesartan and olmesartan/HCTZ hydrochlorothiazide will not be covered by Blue Cross and Blue Shield Kansas (BCBSKS) until multiple manufacturers become available or the price decreases. The innovator products, Benicar and Benicar HCT, will continue to be covered*.

Action Required

If Participating Pharmacies receive a prescription for olmesartan or olmesartan/HCTZ, they must submit brand name Benicar or Benicar HCT in order to receive a paid claim. If a prescription for olmesartan or olmesartan/HCTZ is submitted instead of brand name Benicar or Benicar HCT, the claim will reject at point-of-sale (POS) with the following reject message:

• NCPDP Reject Code 70: "Prod/Service Not Covered"
• Secondary Message: "Generic not covered, Benicar/Benicar HCT covered. Please resubmit for brand. Benicar/Benicar HCT pays at Tier 1 benefit"

For questions regarding coverage of Benicar or Benicar HCT, please refer Covered Persons to the Customer Service number on the back of their BCBSKS ID card.

If you have any questions regarding claims processing, please call the Prime Contact Center at 800.821.4795.

Sincerely, Pharmacy Network Management

Prime Therapeutics LLC

*Coverage of Benicar or Benicar HCT is dependent on the Covered Person’s benefit plan