Specialty Drugs

Specialty drugs, in general, are high-cost prescription medications used to treat complex or chronic medical conditions, such as cancer, rheumatoid arthritis, multiple sclerosis and hepatitis C, among others. These drugs are either self-administered (taken orally or self-injected) or administered by a medical professional in a doctor’s office or other medical facility. Specialty drugs usually require patient-specific dosing and careful clinical monitoring. They may also require special handling and refrigeration. View the Specialty Drug List.

We offer plans that provide different levels of coverage for specialty drugs. Some plans require members to get specialty drugs from CVS Specialty, our preferred specialty pharmacy vendor. CVS Specialty is a division of CVS/Health, an independent company that provides specialty pharmacy services on behalf of BlueCross BlueShield of South Carolina.

Members who are not sure how their health plans covers specialty drugs should check their benefits booklet or talk with their Benefits department. They can also log into My Health Toolkit® for their personal information.

Specialty Medical Benefit Drug Coverage

We also offer these separate management programs for specialty drugs as covered under the member's medical benefit.

Prior Authorization: Some medical (injectable/infusible) specialty drugs require prior authorization. Learn how the Medical Prior Authorization program works and which drugs are included.

 

Self-Administered Drugs: Certain self-administered specialty drugs are only covered under the pharmacy benefit. Learn how the Self-Administered Drug program works and which drugs are included.

Site of Care: Some infused specialty medications must be administered at home or at an infusion suite. Learn more about the Site of Care program and which drugs are included.