Specialty Medications Program
If you have a serious or chronic condition, such as hepatitis C, multiple sclerosis, arthritis, hemophilia and other conditions, you can order certain specialty medications quickly and conveniently through our Specialty Pharmacy Program. Our program has a network of preferred vendors, experienced in managing these medications and providing patient support. Using one of these preferred vendors provides a number of advantages to you and your doctor.
Preferred Specialty Pharmacy Vendors
- Accredo Health Group
- Acro Pharmaceutical Services
- Amerita, Inc.
- BioPlus Specialty Pharmacy
- Caremark Specialty Pharmacy
Advantages for you
- Access to patient care coordinators
- Educational materials
- Ability to call and consult with clinical pharmacists
- Potential savings on specialty medications
- Product delivery anywhere you choose
Advantages for your doctor
- 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
How Specialty Medications are Covered
There are two types of Specialty Pharmacy medications, and coverage of these medications is determined by your medical and prescription insurance plans.
- Provider-Administered Specialty Medications - These specialty medications are ordered by your doctor and administered in an office or outpatient setting. These medications are subject to a copay and will generally be covered by your medical insurance.
- Self-Administered Specialty Medications - You administer these medications to yourself. After your doctor prescribes one of these medications, you should order it from one of the preferred specialty pharmacy vendors listed above. These medications will require a copay and will generally be covered by your prescription insurance.
If you do not have prescription drug insurance through BlueCross BlueShield of Tennessee, self-administered medications will not be covered by your BlueCross BlueShield of Tennessee medical insurance. Check your Evidence of Coverage for more information.
If you have prescription drug insurance through another insurer, check with your employer or plan administrator to determine your coverage level for self-administered medications.
How to Order Specialty Medications
- Find out how your insurance covers specialty medications by calling the Member Service number on your member ID card or by checking your Evidence of Coverage.
- Make sure your specialty medication is on the 2013 Preferred Formulary and Prescription Drug List and have your Doctor obtain prior authorization if required.
- Have your doctor fill out the Specialty Pharmacy Prescription form and send to one of the Preferred Specialty Pharmacies listed above.
- With you prescription information and member ID card handy, call, or have your doctor call, one of the Preferred Specialty Pharmacies listed above to order your medication.