These drugs are available only through the Specialty Pharmacy Network.
Drugs Covered Under the Medical Benefit
If the drug is covered, the word medical will appear after the drug name.
After meeting the medical deductible (if applicable), members pay the coinsurance amount for the cost of the drug. For example, if coinsurance is 20 percent, member payment equals 20 percent of the cost of the drug.
Drugs Covered Under the Pharmacy Benefit
Once members meet pharmacy deductible (if applicable), payment equals the co-pay or coinsurance for the drug.
This list may change as new drugs come on the market or new decisions are made by our Pharmacy and Therapeutics Committee.
***This list does not guarantee coverage and is subject to change.***