Specialty Pharmacy program: This program is designed to support your treatment plan for their condition and facilitate the physician and patient relationship. At the same time, it can help members effectively manage rare or complex diseases and make the most of their benefits by giving them access to the right specialty medications, programs and support  so they can achieve the right results. An integrated approach that includes consistent management across Medical and Pharmacy Benefits, and integrates care coordination by aligning support programs, data and clinical resources available to our members.
Specialty Drugs are not listed in the PDL. Specialty Drugs are all (oral, inhalation, injection)) drugs that cost $500 or more for a 30 days supply. The co-payment for Specialty Drugs is plan dependant. The most common copayment is $50 for a 30 days supply Most Specialty Drugs require a Prior Authorization for coverage.
If you are taking an injectable or specialty medication, call UHC Specialty Referral Line at (866) 429-8177, to locate Medications A-Z or Medications by Condition.
