Specialty Pharmacy Network
In recent years, the use of specialty medications has increased significantly. To ensure that specialty medications remain affordable for our members, BCBSNC contracted with a network of pharmacies committed to providing better pricing on specialty medications.
All Specialty Pharmacies in our network provide next day delivery as long as they receive a valid prescription or prescription transfer. Members will need to contact their specialty pharmacy directly to set up a new prescription. Typically, the process for a new prescription can take between 2 to 4 days. Refills can take place after 75% of the prescription is used (except for controlled substances).
What qualifies a specific medication or therapy to be classified as a specialty pharmaceutical is not clearly defined. However, the following factors help define a specialty medication:
- The medication(s) requires special handling;
- The medication(s) has a limited distribution and can only be filled at certain pharmacies;
- If the medication(s) treats rare disease(s);
- Or if the medication requires ongoing clinical assessment and/ or monitoring of side effects
Specialty medications are most commonly used for chronic diseases such as rheumatoid arthritis and multiple sclerosis. Most specialty medications are injectable and require special handling and administration. Specialty medications are not limited to a specific copayment or coinsurance tier, but can be found in all formulary tier levels. View our specialty medications.
With this specialty pharmacy network there may be a limited number of pharmacies dispensing these medications. Since some pharmacies may choose not to participate in the specialty drug network, you may need to transfer your prescription for specialty medication(s) to a participating local pharmacy or mail order pharmacy.
You can transfer any remaining refills on a prescription from your current pharmacy to participating specialty network pharmacy by providing your prescription information to the new pharmacy. The new pharmacy will either transfer the prescription or obtain a new prescription for you by contacting your physician.
BCBSNC members, who currently have pharmacy benefits and use specialty medications, must use the specialty pharmacy network in order for their prescriptions to be covered. This does not impact Blue Medicare RxSM, North Carolina State Health Plan or Federal Employee Program (FEP) members.
Review the specialty medication list above to see if your medication must be filled at one of the specialty network pharmacies. To locate a specialty network pharmacy near you, please search the Specialty Pharmacy List. If you have any questions about the Specialty Pharmacy Network please call the number listed on the back of your card.
*The specialty medication list is subject to change and is updated regularly.
Office - Administered Specialty Medications
Find out about our network of specialty pharmacies that provide specialty injectable drugs for BCBSNC providers. These pharmacies bill BCBSNC directly, making administering specialty injectable drugs easier for providers and members. You can also check the availability of this program for specific Office-administered specialty medications network and get contact information for participating pharmacies.