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Specialty Self-Injectable Medications

This specialty self-injectable benefit is only available for members with a retail prescription medication benefit through Blue Cross Blue Shield of Arizona.

Specialty self-injectable medications that were previously covered through the retail pharmacy benefit will no longer be covered through retail pharmacy. Click here for a list of injectable medications available under the retail pharmacy benefit.

Members may choose to obtain specialty self-injectable medications from a specialty pharmacy or through the home health benefit. Precertification will be required for the both the specialty injectable benefit and home health benefit and all other exclusions and limitations of your contract/benefit plan apply. Member costs may vary depending on the contract status of the provider and other plan requirements. Please refer to your schedule page and/or renewal notification to determine your cost sharing.

Please note that effective dates for this specialty self-injectable medication benefit may vary depending on your contract/benefit plan's renewal date. Please refer to your schedule page and/or renewal notification to determine when this benefit is effective under your plan.

Certain specialty self-injectable medications are available from a list of specialty pharmacies contracted with Blue Cross Blue Shield of Arizona. To view a list of contracted specialty pharmacies, click here. To confirm the status of a particular specialty self-injectable medication, you may click on the medication listings below or call the Blue Cross Blue Shield of Arizona Customer Service Department at (602) 864-4400 or (800) 232-2345, ext. 4400.

BluePreferred, BlueClassic plans

Specialty self-injectable medications are classified on one of four levels of cost-sharing for which you are responsible. These lists may change at any time without notice. Deductible and coinsurance do not apply to covered specialty self-injectable medications obtained from contracted specialty pharmacies. You pay the applicable copayment. Precertification is required and all other exclusions and limitations of your contract/benefit plan apply. Please refer to your Blue Cross Blue Shield of Arizona schedule page to determine your cost-sharing for specialty self-injectable medications obtained from contracted specialty pharmacies. Specialty self-injectable medications are also available through home infusion providers under your home health benefit (deductible and coinsurance apply).

If you obtain covered specialty self-injectable medications from a specialty pharmacy contracted with Blue Cross Blue Shield of Arizona, your benefits will be processed in accordance with your specialty pharmacy benefit. If you obtain specialty self-injectable medications from a provider other than a specialty pharmacy contracted with Blue Cross Blue Shield of Arizona, your benefits will be processed in accordance with your home health benefit (deductible and coinsurance apply). If a provider is listed as both a specialty pharmacy and a home infusion provider, you may choose which benefit you would like to use. Please discuss this with the provider prior to receiving services. Benefits cannot be changed retrospectively.

To view a list of specialty self-injectable medications,

BluePreferred Basic Plans (Individual Plans only)

Please note that this specialty self-injectable medication benefit is only available if you have a Blue Cross Blue Shield of Arizona Individual BluePreferred Basic plan. Please refer to your schedule page and/or renewal notification to determine whether this benefit is effective under your plan. This specialty self-injectable benefit is not available to Blue Cross Blue Shield of Arizona members who have a group BluePreferred Basic plan. Precertification is required and all other exclusions and limitations of your contract apply. Specialty self-injectable drugs are also available through the home health benefit (deductible and coinsurance apply).

If you obtain specialty self-injectable medications from a specialty pharmacy contracted with Blue Cross Blue Shield of Arizona, your benefits will be processed in accordance with your specialty pharmacy benefit. If you obtain specialty self-injectable medications from a provider other than a specialty pharmacy contracted with Blue Cross Blue Shield of Arizona, your benefits will be processed in accordance with your home health benefit (deductible and coinsurance apply). If a provider is listed as both a specialty pharmacy and a home infusion provider, you may choose which benefit you would like to use. Please discuss this with the provider prior to receiving services. Benefits cannot be changed retrospectively.

BluePreferred Saver plans

Deductible and coinsurance apply to covered specialty self-injectable medications obtained from contracted specialty pharmacies. Precertification is required and all other exclusions and limitations of your contract/benefit plan apply. Please refer to your Blue Cross Blue Shield of Arizona schedule page to determine your cost-sharing for specialty self-injectable medications obtained from contracted specialty pharmacies. Specialty self-injectable medications are also available through home infusion providers under your home health benefit (deductible and coinsurance apply).

If you obtain specialty self-injectable medications from a specialty pharmacy contracted with Blue Cross Blue Shield of Arizona, your benefits will be processed in accordance with your specialty pharmacy benefit. If you obtain specialty self-injectable medications from a provider other than a specialty pharmacy contracted with Blue Cross Blue Shield of Arizona, your benefits will be processed in accordance with your home health benefit. If a provider is listed as both a specialty pharmacy and a home infusion provider, you may choose which benefit you would like to use. Please discuss this with the provider prior to receiving services. Benefits cannot be changed retrospectively.

BlueSelect, BlueChoice plans

Specialty self-injectable medications are available from a list of contracted specialty pharmacies. Copayments will not apply to covered specialty self-injectable medications obtained from specialty pharmacies. Precertification is required and all other exclusions and limitations of your contract/benefit plan apply. Specialty self-injectable medications are also available through the home health benefit. (BlueSelect and BlueChoice customers must utilize network providers, except for emergencies.)
 

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