Are normally injected, infused or require close monitoring by a physician or clinically trained individual; or Often have limited availability, special dispensing and delivery requirements, and/or require additional patient support.
Retail specialty pharmacies and Accredo, the mail order specialty pharmacy, may fill specialty drug prescription orders, subject to a 30-day supply, and subject to the applicable coinsurance or copayment shown in the Schedule of Benefits.
Accredo, Medco’s Specialty Pharmacy provides personalized counseling, expedited delivery, complimentary supplies (such as needles and syringes), and safety checks. If you or a dependent use specialty medications you can order through Accredo. The advantages for you include: Free expedited scheduled delivery to the location you choose (your home, doctor's office, outpatient clinic), and free supplies to administer your medication (e.g., needles, syringes) Individualized support from trained nurses and patient care representatives 24/7 access to registered pharmacists for questions To order specialty medications from Accredo, please call (800) 803-2523 toll-free or have your doctor call (800) 987-4904 between 8 a.m. and 8 p.m., Eastern time, Monday through Friday.
You may call Medco to learn more about Accredo or locate a retail specialty pharmacy and determine if a specialty drug is covered, by calling the Customer Service telephone number on the back of your ID card.
Website Plan members have access to internet features offered through www.medco.com. On this web site, you can refill mail order prescriptions, manage your mail order account, locate a pharmacy, print forms, look up preferred medications and identify cost saving opportunities. Members registered to use the site can also access the Medco Health Store™ to shop for consumer health products. Items available include non-prescription medications and other health-related products that complement prescription drug care.
Covered Prescription Drug Benefits Prescription drugs, unless otherwise stated below, must be Medically Necessary and not experimental/investigative, in order to be Covered Services. For certain prescription drugs, the prescribing physician may be asked to provide additional information before Medco and/or the Plan can determine Medical Necessity. The Plan may, in its sole discretion, establish quantity and/or age limits for specific prescription drugs. Covered Services will be limited based on Medical Necessity, quantity and/or age limits established by the Plan, or utilization guidelines.
Prescription legend drugs Certain OTC medications as indicated under the Affordable Health Care Act* Injectable insulin and needles and syringes used for administration of insulin. Non-insulin needles and syringes Contraceptive drugs: oral, transdermal, intravaginal and injectable
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