Specialty Pharmacies

Specialty pharmacies provide focused care for patients with complex medical needs.

Specialty drugs are used to treat complex, chronic conditions such as cancer, rheumatoid arthritis, and multiple sclerosis. These medications may be taken orally, by injection, or infusion, and often require special handling.

Specialty pharmacies are dedicated to managing these complex therapies and offer:

• Support from clinical experts to help manage your condition and medication side effects
• Guidance on navigating your insurance benefits
• Education on safe and effective medication use

Network specialty pharmacies

To make sure your medication is covered, you may need to fill certain self-administered specialty medications through one of our participating specialty pharmacies.

Medicare plans

Specialty PharmaciesOpen a PDF that Medicare Advantage Prescription Drug Plan members and Dual Special Needs Plan members can utilize to fill specialty medications.

All other plans

• List of specialty medicationsOpen a PDF that could be purchased from a specialty pharmacy
• National Preferred Formulary list of specialty medicationsOpen a PDF that must be purchased from a specialty pharmacy
• List of specialty pharmaciesOpen a PDF that can be used for drugs covered under the pharmacy benefit (self-administered)

Convenient, personalized service

With one toll-free call, specialty pharmacies can:

• Enroll you in their program
• Coordinate with your doctor for prescriptions
• Arrange home delivery

Additional services include:

• Easy refills, reminders, and online ordering
• Education and counseling programs on how to safely and effectively take your medication
• 24/7 access to pharmacists and medical professionals
• Coordination of care with your doctor

Next steps

1. Your physician will prescribe the specialty drug for you and send the prescription to a specialty pharmacy.
2. You will be contacted by an advocate who will explain the specialty pharmacy’s services and coordinate the shipment of your first order.
3. Refills can be ordered online or by calling the specialty pharmacy and speaking with a customer service advocate.

Medicaid drug coverage

As of April 1, 2023, Medicaid members enrolled in Blue Choice Option, HMO Blue Option, and Blue Option PlusUnivera Healthcare MyHealth or MyHealth PlusCDPHP Medicaid plans will receive their prescription medications through NYRx, the Medicaid Pharmacy Program.

To learn more about NYRx, the Medicaid Pharmacy Program, visit the New York State Department of Health of NYRx Website where information of both members and Providers is also available.