May 15, 2019
We are happy to let you know that both Accredo and AllianceRx Walgreens Prime are now in-network pharmacies for specialty medications covered under the medical benefit for the 2019 calendar year.
Please note: This only applies to specialty medications that are covered under a medical benefit plan and are administered by a provider and does not apply to self-administered drugs covered under a pharmacy benefit. Additionally, certain new-to-market or limited distribution drugs may require an alternative specialty pharmacy. Please call the number on the members’ ID card to verify coverage or for questions about their benefits.
Specialty medication coverage is based on the member's benefit plan. This network update does not impact specialty medications that are covered under the pharmacy benefit plan. Members may need to meet select prior authorization criteria before coverage consideration is approved. Providers can find referral forms and additional information at bcbstx.com/provider.
The relationship between BCBSTX and specialty pharmacies is that of independent contractors. Prime Therapeutics has an ownership interest in AllianceRx Walgreens Prime, a central specialty and home delivery pharmacy. BCBSTX contracts with Prime Therapeutics to provide pharmacy benefit management and related other services. BCBSTX, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics.