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What is a specialty drug?
A specialty drug is a medication used to treat complex or chronic conditions that usually requires close patient monitoring. Specialty drugs may be self-administered by injection or inhalation, orally or topically. These drugs may also require special handling and have limited prescribing or limited pharmacy availability. A complete list of specialty drugs is available at the Drug Formulary page.
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How can I use a specialty pharmacy?
Most Blue Shield members are required to obtain covered specialty drugs through our Network Specialty Pharmacies, (check your Evidence Of Coverage to see the days supply allowed by your plan). To fill specialty drugs, members should contact one of Blue Shield’s Network Specialty Pharmacies.
Blue Shield Network Specialty Pharmacies deliver specialty drugs via courier to the location of the member’s choice (home, work, or retail location). The specialty pharmacy provides pharmacist consultation 24 hours a day, 7 days a week and all supplies required for administration of the medication (e.g., needles, syringes, alcohol swabs, sharps containers, etc.), at no additional charge. Medications are always packaged to appropriate handling requirements such as refrigeration.
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What is the approximate turnaround time for specialty drugs to be delivered once the order is complete?
Members should allow three to five business days from the time the prescription order is mailed by a Network Specialty Pharmacies to receive specialty drugs.
Note: You should have at least two weeks of medications on hand before ordering a new prescription through one of the Network Specialty Pharmacies.
Some situations that can delay a prescription from being filled are an incomplete or illegible prescription, incomplete registration with the Network Specialty Pharmacy, prescription drug manufacturer backorders, and prescription drugs that require prior authorization for medical necessity. Most specialty drugs require prior authorization and your Network Specialty Pharmacy can start the request for you.A complete list of specialty drugs is available at the Drug Formulary page.