Specialty medication prescriptions have to be filled at an in-network specialty pharmacy and require:
- Additional education for safe and cost-effective use
- Close monitoring in collaboration with providers
- Specific dosing, medical devices to administer the medicine, and/or special handling or delivery
- Prior authorization before the medication is covered by your plan
Specialty medications are classified as specialty by the letters SGM on the Standard with Step Therapy Formulary.
For more information on prior authorization requirements and network specialty pharmacies, contact 877-433-2973.