Members with serious, chronic conditions can order certain specialty medications quickly and conveniently through the Specialty Pharmacy Program from BlueCross BlueShield of Tennessee. A special network of vendors, experienced in managing these medications and providing patient support, is available for our members and prescribing physicians.
Accredo Health Group
|1-800-237-2767 phone||1-888-773-7376 phone||1-888-239-0725 phone|
|1-800-323-2445 fax||1-888-773-7386 fax||1-866-387-1003 fax|
Walgreens Specialty Pharmacy
Purchasing your specialty medications from these preferred vendors helps you maximize your health care benefits and provides a number of resources to you and your doctor.
Advantages to You
Advantages to Your Doctor
- Patient care coordinators.
- Educational materials.
- Ability to call and consult with clinical pharmacists.
- Potential savings on specialty medications.
- Product delivery anywhere you choose.
Your doctor gains extra support services to help manage your care, such as:
- Compliance management programs to help optimize treatment.
- Disease management programs to actively monitor and manage complex drug regimens.
- Patient care coordinators.
- Ability to consult with clinical pharmacists.
- Reduced need to maintain an inventory of specialty medications.
- Product delivery to his or her office.
The Specialty Pharmacy Program includes high-cost medications for chronic, serious diseases such as hepatitis C, multiple sclerosis, arthritis, hemophilia and other conditions. As noted on the List of Specialty Pharmacy Medications, there are two different types of Specialty Pharmacy medications: provider-administered and self-administered.
Provider-Administered Specialty Medications - These specialty medications are ordered by your doctor and administered in an office or outpatient setting.
How to Order Specialty Medications
Prior Authorization for Specialty Medications
Some specialty medications require prior authorization. Your doctor should check the List of Specialty Pharmacy Medications and obtain prior authorization before administering or prescribing these medications.
How Specialty Medications are Covered
Coverage of these medications is determined by your benefit plan.
Provider-administered specialty medications are subject to a copay and will generally be covered by your BlueCross BlueShield of Tennessee medical benefit. Self-administered specialty medications also require a copay and will generally be covered under your BlueCross BlueShield of Tennessee prescription drug benefit. Check your Evidence of Coverage for more information.
If you do not have prescription drug coverage through BlueCross BlueShield of Tennessee, self-administered medications will not be covered by your BlueCross BlueShield of Tennessee medical benefit. If you have prescription drug coverage through another insurer, check with your employer or plan administrator to determine your coverage level for self-administered medications.