Blue Cross and Blue Shield of Alabama Complies with New Pharmacy Law

Birmingham, AL - Effective October 1, 2025, the Alabama Community Pharmacy Relief Act will change the way Pharmacy Benefit Managers (PBMs) reimburse community pharmacies. The Act was intended to provide financial stability to community pharmacies by increasing reimbursement to the Alabama Medicaid rate. The Alabama Medicaid rate includes the average cost of the drug itself plus a standard amount for the community pharmacist's time and effort to fill the drug (a dispensing fee).

We appreciate the value that our community pharmacies provide our customers and are fully committed to complying with the new law. We also know that changes sometimes can be frustrating and may create confusion for our customers, so we want to be sure they have the information they need.

What is changing?

• On October 1, customers may see changes to the amount they owe when picking up prescriptions at a community pharmacy.

What is not changing?

• Copay amounts. Customers will not pay more than the designated copay for their prescriptions. These set copays are a standard part of each customer's health benefit plan and are available by calling the customer service number on the back of their ID card.
• The way copay amounts and out of pocket costs are applied. Health plans have always required customers to pay the lesser amount of the cost of the drug (which includes the dispensing fee) or the designated copay.
• Medicare Plans, including Blue Advantage and Blue RX, are not impacted by the new law.

In other words, the way prescription drug costs are calculated will not change, which is consistent with the Act; and a customer's out-of-pocket cost will not be higher than the set copay amount outlined in their health benefit plan.

"We know that rising prescription costs can place a burden on individuals and families," said Dorinda Cale, Vice President of Pharmacy Services at Blue Cross and Blue Shield of Alabama. "These changes stem from changes to the law - not a decision that we or our PBM partner made. We remain firmly committed to advocating for lower drug prices on behalf of our customers."

For questions, members can call the customer service number on the back of their ID card.

About Blue Cross and Blue Shield of Alabama

Blue Cross and Blue Shield of Alabama has insured Alabamians for over 89 years. Blue Cross offers coverage plans to corporations, individuals and the senior market. For more information about Blue Cross, visit AlabamaBlue.com. Connect with us on Facebook, check out our videos on YouTube and follow us on X for more up-to-date information.

Blue Cross and Blue Shield of Alabama is an independent licensee of the Blue Cross and Blue Shield Association.