Specialty Drug List

Our Specialty Drug List includes drugs that are billed under the pharmacy benefit, as well as some that are billed under the medical benefit. For drugs billed under the pharmacy benefit, most of our members are required to use CVS/specialty, our preferred specialty pharmacy vendor. CVS/specialty is a division of CVS Health, an independent company that provides pharmacy benefit management and specialty pharmacy services on behalf of BlueCross. Please note: Beginning June 1, 2016, some members have a plan that will block certain self-injectable drugs under the medical benefit and only cover them under the pharmacy benefit. These drugs are noted on the specialty drug list.

Some specialty drugs require prior authorization. Please see the list to determine where to request prior authorization, based on whether the drug will be billed under the member's medical or pharmacy benefit. Beginning June 1, 2016, providers will use CVS/caremark's medical prior authorization system to request prior authorization under the medical benefit.