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BCBSIL Now Offers a Choice in Pharmacies for Specialty Medications

Posted April 29, 2019

We are happy to let you know that both Accredo® and AllianceRx Walgreens Prime are now in-network pharmacies for specialty medications covered under the Blue Cross and Blue Shield of Illinois (BCBSIL) medical benefit for the 2019 calendar year.

Please note: This network update only applies to provider-administered specialty medications that are covered under the medical benefit for eligible BCBSIL members. It does not apply to self-administered drugs covered under the pharmacy benefit. Also, certain new-to-market or limited distribution drugs may require an alternative specialty pharmacy. Please call the number on the members’ ID card to verify coverage, or for questions about their benefits.

Specialty medication coverage is based on the member's benefit plan. This network update does not impact specialty medications that are covered under the pharmacy benefit plan. Members may need to meet select prior authorization criteria before coverage consideration is approved. Providers can find referral forms and additional information in the Pharmacy Programs section

This information does not apply to government programs members.

The listing of any particular drug or classification of drugs is not a guarantee of benefits. Members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions.

The relationship between BCBSIL and specialty pharmacies is that of independent contractors. Prime Therapeutics has an ownership interest in AllianceRx Walgreens Prime, a central specialty and home delivery pharmacy. BCBSIL contracts with Prime Therapeutics to provide pharmacy benefit management and related other services. BCBSIL, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics.