What Are Specialty Drugs?

When you're fighting cancer or dealing with a difficult condition like multiple sclerosis, you may need something we call specialty drugs.

They typically require special handling, administration or monitoring. It's also likely they'll need prior approval before your Blue Cross Blue Shield of Michigan plan will help pay for them. Some can only be filled by a specialty pharmacy. 

• In your member account select Prescription under My Coverage. Then select Find & Price Medications.
  
  
• On the app, select prescription under My Coverage. Then select the link for Find and Price Medications.
  

You'll need the name of the drug. It's helpful to know the dosage your doctor prescribed.

• Drug lists can't tell you the price of a prescription. But you can see if a prescription is considered a specialty drug, and whether it needs prior authorization before your prescription drug plan will help pay for it.
• Find your plan's drug list.
• If you already know your prescription is a specialty drug, you can get more information about it in the Specialty Drug Program Rx Benefit Member Guide (PDF). It also tells you where and how to fill your prescription.

We can answer questions about a specialty drug during business hours. Contact us and we'll help.

Most specialty drugs can be filled at a retail pharmacy or by mail order through Walgreens Specialty Pharmacy. Some specialty drugs can only be ordered and delivered by mail from one pharmacy.

If your doctor didn't send in the prescription for you, use the Specialty Drug Program Rx Benefit Member Guide (PDF) to look up your drug and find out where and how to fill your prescription. 

You may have a pharmacy benefit design that requires you get specialty drugs from our exclusive pharmacy network for specialty drugs. Walgreens Specialty Pharmacy is our exclusive specialty pharmacy network provider. To find out if you must use Walgreens Specialty Pharmacy or a retail Walgreens pharmacy for your specialty pharmacy prescriptions, log in to your member account.

Whether you get them at a pharmacy or by mail order, Blue Care Network HMO plans limit most specialty drugs to a 30-day supply. Some Blue Cross Blue Shield of Michigan PPO plans do, too.

Some drugs are limited to a 15-day supply. They're listed on the 15-day Specialty Drug Limitation Program (PDF). If you have a copay for your prescription, you only pay half of it for these drugs.