Pharmacy | 2022 | MedicalPharmacy – Specialty Prescriptions
How It Works
(Out-of-network pharmacy expenses are not covered; For Retail & Mail-order medications, see Pharmacy – Retail & Delivery.)
CVS/Caremark Specialty Pharmacy
1-800-237-2767 (TTY: 711)
Accredo Specialty Pharmacy
Accredo Health Group, Inc.
1640 Century Center Parkway,
Memphis, TN 38134
Accredo, one of the top specialty pharmacies in the nation, offers a high level of customer service. Members have access to Accredo’s mobile apps; free standard delivery in weather-proof packaging; specialty-trained pharmacists, nurses and insurance representatives; and automatic refill reminders.
- Member co-payments will remain the same. For members with coinsurance or who pay out of pocket until a deductible is met, costs could be lower.
- Accredo offers members health condition-specific clinical support and education.
- Accredo’s mobile app makes it easy manage your prescriptions.
- Turnaround time for refills is typically 24-48 hours.
- To self-register, go to accredo.com/flblue. Create an account, add a payment method and update your profile. You may view your active prescriptions and send your refill order when you’re ready or calll Accredo at 888-425-5970.
Payments can be made via any of these methods:
- By debit or credit card (American Express, Discover, MasterCard or Visa). The charge will appear on your credit card statement as Accredo.
- Through your checking account.
- Through a flexible spending account (FSA).
- By mail via check.
For payments, send checks to:
Accredo Health, Inc.
PO Box 954041
St. Louis, MO 63195
NOTE: Please include your patient account number on your check.
Prime Therapeutics is the current Pharmacy Benefit Manager for Duval County Public Schools.
Visit Prime Therapeutics’ website, www.myprime.com, to view your plan design and copayment information, search for details on prescription medications, locate a participating pharmacy near you, and manage your home delivery prescriptions. For additional plan inquiries, you may call Member Services directly at 1-800-664-5295. For future reference, this number is listed on the back of your Florida Blue ID card.
Benefit ID Cards
Present your ID card when filling a prescription at the pharmacy. Should you need additional or replacement ID cards, please contact Member Services or visit www.floridablue.com to either request a new card or print a temporary card.
Federal legend prescription drugs, unless otherwise indicated;
- Drugs requiring a prescription under the applicable state law;
- Insulin, insulin needs and syringes on prescription; or
- Compound medications, of which at least one ingredient is a federal legend drug.
Medication Step Therapy
Step Therapy requires the previous use of one or more drugs before coverage of a different drug is provided. If your health plan’s formulary guide reflects that Step Therapy is used for a specific drug, your physician must submit a prior authorization request form to the health plan for approval. If the request is not approved, please remember that you always have the option to purchase the medication at your own expense.
Prior authorization is required on some medications before your drug will be covered. If your health plan’s formulary guide indicates that you need a prior authorization for a specific drug, your physician must submit a prior authorization request form to the health plan for approval. If the request is not approved, please remember that you always have the option to purchase the medication at your own expense.
Quantity limits are applied to certain drugs based on the approved dosing limits established during the FDA approval process. Quantity limits are applied to the number of units dispensed for each prescription. If your health plan’s formulary guide reflects that there is a quantity limit for a specific drug, your physician must submit a prior authorization request form to the health plan for approval. If the request is not approved, please remember that you always have the option to purchase the medication at your own expense.
Formulary exceptions are necessary for certain drugs that are eligible for coverage under your health plan’s drug benefit. Your physician must submit a formulary exception form to your health plan for approval. If the request is not approved by the health plan you may still purchase the medication at your own expense. The general form can be used if the drug you are requesting coverage for is not on the formulary list.
Prescription Copay Summary: Retail and Mail Order
Out of Network Retail and Mail Order Pharmacy expenses are not covered.
Note: Specialty Drugs are not available through Mail Order Pharmacy. For more information, please contact customer service at 800-664-5295.
|NON-CONTRIBUTORY PLAN||CONTRIBUTORY PLAN||HIGH DEDUCTIBLE HEALTH PLAN (HDHP)*|
|30-Day Supply||Calendar Year Deductible (CYD) MUST be met then:|
|Generic - Formulary||$7||$7||CYD + $7|
|Brand - Formulary||$25||$25||CYD + $25 + 10% Coinsurance|
|Non-Formulary||$40||$40||CYD + $40 + 10% Coinsurance|
|Specialty Injectables||$55||$55||CYD + $55 + 10% Coinsurance|
|90-Day Supply||Calendar Year Deductible (CYD) MUST be met then:|
|Generic - Formulary||$14||$14||CYD + $14|
|Brand - Formulary||$50||$50||CYD + $50 + 10% Coinsurance|
|Non-Formulary||$80||$80||CYD + $80 + 10% Coinsurance|
|*HDHP W/HSA: Rx costs go to deductible. Once deductible is met, then employee pays copay for generic and copay+10% for all other Rx.|