CHAPEL HILL – Blue Cross and Blue Shield of North Carolina (BCBSNC) is establishing a new network of specialty pharmacies to help customers better manage their complex, chronic health conditions and to address the rising costs of these prescription medications. These network changes will not affect customers’ prescription drug benefits in any way and customers may continue to receive non-specialty medications at any pharmacy in BCBSNC’s pharmacy network.
- Specialty pharmacy network provides customers with nursing or pharmacist services 24 hours a day, disease specific evaluations and other benefits.
- Specialty medication costs are expected to rise 13 to 15 percent annually over the next few years. BCBSNC’s new specialty pharmacy network is expected to moderate these increases.
- Change does not affect Medicare Part D customers.
The BCBSNC specialty pharmacy network consists of pharmacy providers that have met rigorous criteria, including quality accreditation through URAC, a national and independent organization that promotes health care quality and efficiency. Pharmacies who meet the network criteria will offer the following comprehensive services:
- Available nursing or pharmacist services 24 hours a day, 7 days a week, 365 days a year.
- Disease specific initial and ongoing evaluations, monitoring of medication adherence and counseling.
- Convenient mail order service, with delivery to a customer’s location of choice.
Specialty medications are costly drugs that typically treat chronic conditions such as multiple sclerosis and rheumatoid arthritis. Specialty medications can be received through a customer’s medical or pharmacy benefits. These types of drugs often require special preparation and handling, such as mixing and refrigeration. Specialty drugs are typically those in tier 4 of BCBSNC’s prescription drug formulary. All pharmacies in the new network are specially equipped to handle dispensing specialty medications.
“The specialty pharmacies in our new network have met strict criteria for participation, including accreditation through an independent accrediting organization,” said Estay Greene, director of BCBSNC pharmacy programs. “These pharmacies have demonstrated their ability to offer comprehensive medication support to our customers.”
Specialty medication costs are on the rise, expected to increase 13 to 15 percent annually over the next few years. BCBSNC expects the new specialty pharmacy network to help moderate these increases. Specialty pharmacies in BCBSNC’s new network have staff available to help answer questions about medications, offer financial counseling and provide other support services.
Customers will still be able to receive non-specialty medications at any pharmacy in BCBSNC’s pharmacy network. The establishment of this specialty pharmacy network does not affect prescription drug benefits in any way.
Letters will be mailed to all individual customers who are affected by the change and include detailed information and instructions. Beginning July 1, customers can begin transferring any remaining refills on specialty prescriptions from their current pharmacy to a pharmacy in the new specialty pharmacy network. By Aug. 15, 2011, all affected customers must use pharmacies within the specialty pharmacy network for their specialty medications in order to receive in-network benefits. The change does not impact BCBSNC’s Medicare Part D customers.
For additional information, customers are asked to contact BCBSNC at the toll-free customer service number listed on their ID card or visitwww.bcbsnc.com.
Pharmacies participating in BCBSNC’s specialty pharmacy network as of July 1, 2011:
- Ascend Specialty Rx
- BioPlus Specialty Pharmacy
- CommCare Pharmacy
- CVS Caremark
- DrugCo Health
- Kerr Health
- Long’s Drugs
- MedPro Rx
- US Bioservices
Blue Cross and Blue Shield of North Carolina is a leader in delivering innovative health care products, services and information to more than 3.7 million members, including approximately 900,000 served on behalf of other Blue Plans. For 77 years, the company has served its customers by offering health insurance at a competitive price and has served the people of North Carolina through support of community organizations, programs and events that promote good health. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Access BCBSNC online at http://www.bcbsnc.com .