Effective January 1, 2016, Prime Therapeutics (Prime) will begin processing Medicare Part D and Part B claims for Covered Persons of Blue Cross Blue Shield of Texas (BCBSTX) Blue Cross Medicare Advantage (HMO SNP) Processing Requirements To ensure uninterrupted service to Participating Pharmacies and Covered Persons, please use the following information to set up your system prior to January 1, 2016.

Effective January 1, 2016, Prime Therapeutics (Prime) will begin processing Medicare Part B claims for the Chicago Teachers’ Pension Fund Covered Persons of Blue Cross Blue Shield of Illinois (BCBSIL) Medicare Advantage (PPO) Processing Requirements To ensure uninterrupted service to Participating Pharmacies and Covered Persons, please use the following information to set up your system prior to January 1, 2016.

Effective January 1, 2016, Prime Therapeutics (Prime) will begin processing Medicare Part D and Part B claims for Covered Persons of Alignment Health Plan. Processing Requirements To ensure uninterrupted service to Participating Pharmacies and Covered Persons, please use the following information to set up your system prior to January 1, 2016.

Please download attached PDF file for more information.

Commercial Effective December 1, 2015 • Glumetza is excluded from the prescription benefit. The physician will not be able to request a prior authorization for continued coverage. • Capsaicin and menthol containing patches are excluded from the prescription benefit. The physician will not be able to request a prior authorization for continued coverage. • Specialty medications are limited to up to a 31 day supply fill. The physician will not be able to request a prior authorization for a larger day supply.