Dear Valued Provider,

On October 26, 2016, generic Benicar and Benicar HCT (olmesartan and olmesartan/HCTZ) will become available to the market. Olemesartan and olmesartan/HCTZ will not be covered by Blue Cross and Blue Shield of Alabama until multiple manufacturers become available or the price decreases. The innovator products Benicar and Benicar HCT will continue to be covered with a tier 1 copay*.

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 HCT tablets 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: Olmesartan and Olmesartan HCT not covered, use Benicar or Benicar HCT

For questions regarding coverage of Benicar or the new product, please refer Covered Persons to the Customer Service number on the back of their Blue Cross 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 and Benicar HCT is dependent on the Covered Person’s benefit plan

* For State of Alabama Covered Person’s only – brand Benicar and Benicar HCT will continue to process with a tier 4 copay.

* For Auburn University Covered Person’s only – brand Benicar and Benicar HCT will process with a tier 2 copay.