Pharmacy Members to Have New Home Delivery and Specialty Pharmacy Options Starting Aug. 1

May 5, 2021

Pharmacy Members to Have New Home Delivery and Specialty Pharmacy Options Starting Aug. 1

What’s happening: Our pharmacy benefit manager (PBM), Prime Therapeutics^®, signed an agreement to provide its health plan clients, including Blue Cross and Blue Shield of Texas (BCBSTX), another home delivery and specialty pharmacy option through the Express Scripts^® Pharmacy and Accredo^®, a full-service specialty pharmacy.

We have elected to adopt Express Scripts^® Pharmacy for home delivery and Accredo for specialty pharmacy services starting Aug. 1, 2021. This will go into effect for our employer group and retail plans. Please note: For our Medicaid and Medicare plans, these pharmacy services are being added to the network as an option for members to use.

Why the transition: Working closely with Prime, we continue to assess our pharmacy networks and benefit offerings to provide services and solutions that put members first and deliver total health value. Our pharmaceutical management strategy produces improved health outcomes, an unrivaled customer and partner experience and lowers overall health care costs.

This pharmacy service agreement provides the capabilities, customer service focus and competitive pricing that BCBSTX and Prime continue to prioritize for all members. The agreement also fosters our industry-leading integrated medical and pharmacy solution.

The impact: With this agreement, members and employer group customers can expect:

Potential lower drug costs and improved pharmacy access, delivered by our combined scale and purchasing power.
Competitive home delivery and specialty pharmacy options with two of the largest and most respected home delivery and specialty pharmacies in the nation.
Access to 99.9% of all specialty medications on the market, including many of those considered “limited distribution” and unavailable from other specialty pharmacies.
Fifteen condition-specific specialty drug therapeutic resource centers focused on individualized counseling and education to help improve members’ overall health outcomes.
Digital tools, such as mobile applications and text messaging campaigns, to provide a more engaged and seamless member experience.
A next-generation approach to drug management that continues to provide services and solutions delivering quality, affordable care.

Member notices and support: Any transitioning members (those noted above) will be sent a letter at least 30 days prior to the change effective date. The letter will list the steps they need to take on or after Aug. 1, 2021.

If members transition to Accredo or want to get started with Accredo after Aug. 1, they will be managed by a dedicated onboarding support team. The team will help members register and complete their first fills after the change effective date. All first fills will be conducted with an agent over the phone to make sure patient profiles are complete and future condition-specific support resources are set up appropriately.

Questions? Stay tuned for more information about these new pharmacy services, including any member notifications. If you have any questions, contact your BCBSTX representative.

This information applies to members and groups with prescription drug benefits administered through Blue Cross and Blue Shield of Texas (BCBSTX).

BCBSTX contracts with Prime Therapeutics to provide pharmacy benefit management and related other services. The relationship between BCBSTX and contracting pharmacies is that of independent contractors. BCBSTX, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics. MyPrime.com is an online resource offered by Prime Therapeutics. Prime Therapeutics has an ownership interest in AllianceRx Walgreens Prime, a central specialty and home delivery pharmacy.

Accredo is a specialty pharmacy that is contracted to provide services to members of BCBSTX. The relationship between Accredo and BCBSTX is that of independent contractors. Accredo is a trademark of Express Scripts Strategic Development, Inc.

Express Scripts^® Pharmacy is a pharmacy that is contracted to provide mail pharmacy services to members of BCBSTX. The relationship between Express Scripts^® Pharmacy and BCBSTX is that of independent contractors. Express Scripts^® Pharmacy is a trademark of Express Scripts Strategic Development, Inc.

Express Scripts is an independent company and is solely responsible for the products and services that it provides.

Blue Cross^®, Blue Shield^® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans.