Specialty Pharmacy Medications are high-cost injectable, infused, oral or inhaled medications that generally require close supervision and monitoring of the patient’s therapy.

Specialty Pharmacy Medications are divided into two categories:

Self-Administered – Patients self-administer these medications themselves. For many members these drugs are only covered by their pharmacy benefit and are available at the lowest cost share when obtained from a participating Specialty Pharmacy provider.

Current listing of Self-Administered Specialty Medications (PDF)

Provider-Administered – These medications are ordered and administered in an office or outpatient setting. For many members these drugs are only covered by their medical benefit.

Current listing of Provider-Administered Specialty Medications (PDF)

Note: Certain medications are noted as either Self-Administered and/or Provider-Administered and are covered in either setting.

Participating Specialty Pharmacy Provider

Advocate+TM Pharmacy Match Specialty Pharmacy Network 
Specialty pharmacies help a member receive and manage their self-administered specialty medication. These pharmacies deliver medication right to a member’s home within all U.S. states and territories, and pharmacists are available 24 hours a day to answer questions. 

Advocate+ Pharmacy Match expands our plan’s specialty pharmacy network and matches a member with a highly qualified pharmacy to fill their specialty medication. Important: Any other pharmacy is considered out-of-network for specialty medications even if it is in-network for other non-specialty medications. Members should only use the specialty pharmacies in the Advocate+ Pharmacy Match Specialty Pharmacy Network to ensure their medication will be covered. 

Getting Help
•    Members may get help with their self-administered specialty medications by calling Advocate+ Member Support at 1-833-950-3858. 
•    Providers who need assistance with sending their commercial Florida Blue patient’s self-administered specialty prescription, may contact:
Advocate+ Prescriber 
Phone: 1-877-787-0520 (option 2 for pharmacies; option 3 for prescriber) 
Fax: 1-833-998-4435 
NCPDP: 6013914 
NPI: 1366292880 

Special Circumstances 
For the three medication types listed below, please use only the pharmacies listed here. 

1. Specialty Self-Administered hemophilia medications will be listed on the drug list with 
“SP.” Please use: 
CVS/Caremark Hemophilia Services 
Phone: 1-866-792-2731 
Fax: 1-866-811-7450 
CVS Caremark Specialty Hemophilia 

2. Specialty Provider-Administered Medications. Please use: 
CVS/Caremark Specialty Pharmacy Services 
Phone: 1-866- 278-5108 
Fax: 1-800-323-2445 
CVS Caremark 

Specialty Provider-Administered Medications administered by a health care professional may be ordered by a provider directly or they may send the prescription to CVS/Caremark Specialty or through a limited distribution pharmacy to bill the member’s medical benefits. 

3.    Specialty Provider-Administered long-acting mental health medications listed on the limited distribution drug list under the member’s pharmacy benefit will be listed on the drug list with “SP”. Please use: Genoa Healthcare

Note: Self-insured health plans may not include the Advocate+ Pharmacy Match specialty pharmacy network. To determine if a health plan is self-insured, members can check the front of their member ID card to see if it says “self-insured.” If they are not sure or need help, they may call Customer Service at the number on the back of their card. 

Health plans that are not enrolled in Advocate+ Pharmacy Match specialty pharmacy network will use the exclusive Specialty Pharmacy Network, serviced by Accredo and CVS Caremark specialty pharmacies, in conjunction with Limited Distribution Drug pharmacies. Unless indicated below, any other pharmacy is considered a non-participating Specialty Pharmacy even if it participates in Florida Blue’s networks for non-Specialty Pharmacy medications. If they use a different specialty pharmacy, the member may have to pay higher out-of-pocket costs.

CVS/Caremark Specialty Pharmacy Services 
Provider-Administered and Self-Administered Products 
Phone: 1-866-278-5108 
Fax: 1-800-323-2445 
CVS/Caremark Specialty Pharmacy 

Accredo 
Self-administered Products; excluding Hemophilia 
Phone: 1-888-425-5970 
Fax: 1-888-302-1028 
Accredo 

Note: Specialty Pharmacy medications are not covered when purchased through the mail-order pharmacy.