Prescription drugs are covered in two ways—through the Healthy Blue pharmacy benefit or via medical benefit. The method of coverage depends on whether the drug is self-administered or administered by a health care professional at home (ex. home infusion therapy) or given in a clinical setting like a doctor’s office.
Drugs that are only administered to members by healthcare professionals are available under the medical benefit and can be obtained in several ways:
For more information on the North Carolina Physician Administered Drug Program (PDP), please visit the Physician Administered Drug Program page.
For more information on self-administered prescription drugs and pharmacy benefit coverage, please visit our Healthy Blue pharmacy page.
CVS Specialty® is an independent company providing pharmacy services on behalf of Healthy Blue.
Healthy Blue is pleased to announce a drug delivery option that enhances medication accessibility to both members and providers. Healthy Blue is contracted with CVS Specialty® as the MSP. CVS Specialty® can deliver member specific medication that is covered under the Healthy Blue medical benefit to your office for administration to the member.
To set up delivery or check a prescription order status please call 877-254-0015 and you will be transferred to a pharmacist for a verbal prescription order. Please plan to provide your member's Healthy Blue ID located on their ID card. Staff will obtain additional information necessary to support the delivery of the medication, including the need by date. Please allow up to 10 days for processing and shipping. The staff will then make an outbound call to your member to obtain consent as needed to support the delivery of the medication to your office. Once all necessary information is obtained for shipping, the staff will make an outbound call to your office to confirm delivery.
You may also fax prescription orders to 866-336-8479, and a staff member will call your office to obtain additional information necessary to support the delivery of the medication as described above.
Note: If it is an urgent medication request and the need by date is less than 7 days from the order date, please indicate this, so the order can be expedited.
Home infusion therapy is the administration of prescription legend drugs through intravenous, intraspinal, epidural, or subcutaneous routes from the comfort of the member’s home. HIT is prescribed by a physician that both the physician and Healthy Blue have determined to be medically necessary and must supervised by a qualified health care professional to the member in their residence.
To find an in-network HIT provider please use our Find a Pharmacy tool.
Need to get a specialty prescription filled or find an in-network provider? Find a plan pharmacy nearby.