Specialty Pharmacies

Specialty drugs are high cost prescription medications designed for complex, chronic conditions like cancer, rheumatoid arthritis and multiple sclerosis. Specialty drugs may be oral or given by injection or infusion. Some may require special handling and administration.

If you’re enrolled in a Commercial or Exchange product:
Your prescription benefit may require that select specialty medications must be purchased from one of our participating specialty pharmacies in order to receive coverage under your prescription drug benefit (for medications that are self-administered).

Follow this link for a list of specialty medicationsOpens a PDF that could be purchased from a specialty pharmacy.
Follow this link for a National Preferred Formulary list of specialty medicationsOpen a PDF that must be purchased from a specialty pharmacy.

Specialty pharmacies focus on you and your individual health care needs.
Because they work exclusively with specialty medications, they are experts in handling and administering these complex medications. Many specialty medications are self-administered by injection.

Specialty Pharmacies Make Your Life Easier
With a single, toll-free phone call they take care of all the details - they will enroll you in the program, contact your doctor for your prescription, and arrange delivery to your home. Some of the services they offer include:

  • Easy refills, refill reminders, and online ordering.
  • Education and counseling programs to meet your needs and detailed instruction on how to safely and effectively take your medication.
  • A team of dedicated pharmacists and medical professionals are available to answer your questions 24 hours a day, 7 days a week via toll-free telephone.
  • Coordination of care with your doctor.

Patient Enrollment
The enrollment process for new patients is simple.

You or your doctor can contact the participating specialty pharmacy to enroll. If you initiate contact with the specialty pharmacy, the specialty pharmacy will contact your physician office for a new prescription.

The specialty pharmacy can then contact you to provide disease state and drug specific education and arrange shipment of the medication.

Network Specialty Pharmacies
Follow this link for a list of specialty pharmaciesOpens a PDF that can be used for drugs covered under the pharmacy benefit (self-administered).

Attention Univera Healthcare MyHealthSM and MyHealth PlusSM members!

Beginning April 1, 2023, all Medicaid members enrolled in Univera MyHealth and Univera MyHealth Plus will receive their prescription drugs through NYRx, the Medicaid Pharmacy Program.

Learn more about the transition of the pharmacy benefit from Univera MyHealth and Univera MyHealth Plus to NYRx, the Medicaid Pharmacy Program.

Access general information about NYRx, the Medicaid Pharmacy Program, along with additional information for Members and Providers.

 

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