Specialty drugs are expensive injectable, infusible and ingestible medications used to treat serious, chronic conditions such as multiple sclerosis, rheumatoid arthritis, cancer and hemophilia. The drugs often require special handling, monitoring during treatment and education. Some specialty drugs must be given in a doctor’s office (provider-administered), but others can be self-administered at home.
BlueCross’ Specialty Pharmacy Network includes experts who have experience with these high-cost, biological drugs. When your doctor faxes your prescription to the specialty pharmacy, your drugs will be sent to your home or other designated location. If you have questions about your medicine, our pharmacists are available to answer them.
Our specialized network of pharmacies, experienced in managing these medications and providing patient support, is available for our members and prescribing physicians at no cost. Some of the advantages available to members include:
View the 2017 Preferred Formulary and Prescription Drug List / Preferred Specialty Pharmacy Network to see if your medication is classified as a specialty medication.
There are two different 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.
Self-Administered Specialty Medications – You administer these medications to yourself. After your provider prescribes one of these medications, you should order it from one of BlueCross BlueShield of Tennessee’s preferred specialty pharmacies.
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.
Specialty medications require prior authorization. Your doctor should check the 2017 Preferred Formulary and Prescription Drug List and obtain prior authorization before administering or prescribing these medications.
Have your doctor fill out the Specialty Pharmacy Prescription form and send to one of the Preferred Specialty Pharmacies listed above. Print the Prescription Form.
Collect your prescription information and member ID card. Call, or have your doctor call or fax one of the preferred Specialty Pharmacies to order your medication.
Purchasing your specialty medications from our Specialty Pharmacy network helps you maximize your health care benefits.
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