Effective May 5, 2017, Blue Cross and Blue Shield Kansas (BCBSKS) will begin to cover the AB rated generics for Benicar (olmesartan) and Benicar HCT (olmesartan/hydrochlorothiazide).

The generic for Benicar and Benicar HCT recently became available in the marketplace; however, effective November 18, 2016, the plans listed in the attached PDF will continue to cover the brand name Benicar and Benicar HCT at the Preferred Brand Tier.

*Please see attached PDF for more information.

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

Dear Valued Provider,

On October 26th, 2016, generic Benicar and Benicar HCT (olmesartan and olmesartan/ HCTZ) will become available to the market. Olmesartan and olmesartan/HCTZ will require a Prior Authorization by Florida Blue until multiple manufacturers become available or the price decreases. The innovator product Benicar/HCT will continue to be covered*.

Action Required

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

• NCPDP Reject Code 75: Prior Authorization
• Secondary Message: "Brand Benicar/HCT preferred, generic requires PA"

For questions regarding coverage of Benicar/HCT or the new product, please refer Covered Persons to the Customer Service number on the back of their Florida Blue 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

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.