Not all benefit plans are the same. And prior authorization requirements are not the same for all members. Members who are not sure how their health plan covers specialty drugs should check their benefits booklet or talk with their Benefits department. They can also log into My Health Toolkit® for personal information about their prescription drug coverage.
Some of our plans provide a different level of coverage for specialty drugs. And with some plans, members must use a Caremark Specialty Pharmacy Services pharmacy for specialty drug prescriptions. On behalf of BlueCross, Caremark Specialty Pharmacy Services administers this program. Caremark Specialty Pharmacy Services is an independent company that dispenses specialty drugs and provides other related services.
Some specialty drugs need prior authorization before we will cover them. To request prior authorization for specialty drugs, providers should call Caremark at 866-814-5506. Providers can also fax a form request to Caremark at 888-836-0730. Your request should include the patient's name, ID number, date of birth, address, telephone number and the strength and name of the drug. You should also include your name, office address, telephone and fax number.
