Starting in 2014, IBC will introduce a new pharmacy network called the 
FutureScripts Preferred Pharmacy Network. This network is a smaller version of 
our full FutureScripts pharmacy network. The FutureScripts Preferred Pharmacy 
Network allows us to offer members a lower premium. 
With this preferred network, members will continue to have access to more than 
50,000 pharmacies, such as CVS, Wal-Mart, and Target, in addition to 
independent pharmacies. The FutureScripts Preferred Pharmacy Network 
specifically excludes Walgreens and Rite Aid. 
The FutureScripts Preferred Pharmacy Network is offered with the following base 
plans: 
Keystone HMO Bronze 
Keystone HMO Gold Proactive 
Keystone HMO Silver Proactive 
Personal Choice Catastrophic 
Personal Choice PPO Bronze
Personal Choice PPO Bronze Reserve 
Pharmacies that are not part of the FutureScripts Preferred Pharmacy Network 
(i.e., Walgreens and Rite Aid) are considered non-participating or 
out-of-network for members who are covered under these products. If a member 
elects to get a prescription filled at Walgreens or Rite Aid, it will be 
considered an out-of-network claim and the member will be responsible for the 
total cost of their prescription drug(s) at the time of purchase. Some members 
can submit a paper claim for partial reimbursement. 
If you have any questions about this new pharmacy network, please call Customer 
Service at 
1-800-ASK-BLUE. 
Independence Blue Cross offers products directly, through 
its subsidiaries Keystone Health Plan East and QCC Insurance Company, and with 
Highmark Blue Shield — independent licensees of the Blue Cross and Blue 
Shield Association.
FutureScripts® and 
FutureScripts® Secure are independent companies that provide 
pharmacy benefits management services.
The Blue Cross and Blue Shield names and symbols are 
registered marks of the Blue Cross and Blue Shield Association, an association 
of independent Blue Cross and Blue Shield plans.