Check to see if your drug is one that you’ll give yourself (Preferred Medication List) or if it’s one your doctor gives in their office (Provider Administered Specialty Medication List). There’s a list for each. If your drug isn’t covered, ask your doctor if there’s another similar one that might work. If not, ask them to request that we cover it for you, specifically. We call this an “exception.”

We’ve put together a list of specialty pharmacies that are trained to handle these types of drugs and can give them at the most affordable cost possible. If you want us to help you pay for your drug, you’ll need to use one of them.

Typically, once your doctor prescribes your drug, they’ll order it for you, and you’ll get a call from the specialty pharmacy when it’s ready to be filled.

Your doctor or specialty pharmacy will work with you directly to make sure you get what you need, check for any help with paying for your drugs, and even work out a payment plan, if you need it. You’ll pay the pharmacy directly, before you get the treatment.

Ask your specialty pharmacist if there are any financial help programs available for your drug. Sometimes the manufacturer offers help with the cost. You can also ask your pharmacy for help making a payment plan.