A specialty medication is used to treat complex and chronic conditions like rheumatoid arthritis, multiple sclerosis, human immunodeficiency virus (HIV), psoriasis, rare genetic disorders, infertility and cancer. A specialty medication is sometimes taken as a pill but is most often injected or infused. It tends to be high cost and those who take specialty medications may need extra monitoring or support.
You can check the CVS Specialty Drug List to see if your medication is available through CVS Specialty by signing into CVSspecialty.com.
Please note: Most specialty medications require prior authorization (PA) before they can be covered by your plan. This means that your doctor must provide more information to your insurance company or pharmacy benefit manager on why you need a specialty medication. On average, the process takes about a week for your insurance company to approve or deny the request. But we’ll work to get your medication to you as quickly as possible. If approved, your medications will be covered based on your plan and we’ll contact you to schedule delivery.
Ask your doctor to send your prescription to CVS Specialty. Your doctor can e-prescribe, call 1‑800‑237-2767 or fax your prescription to 1-800-323-2445.
What can I expect when I get started with CVS Specialty?CVS Specialty offers a higher level of support than traditional retail pharmacies. You’ll have access to a CareTeam, which includes clinical pharmacists and nurses who are specially trained for conditions like yours. They can help with everything from getting started, setting up injection training or home infusions, helping you manage side effects and connecting you with financial assistance programs.
Here’s how the process works:
When CVS Specialty receives your prescription, a member of your CVS Specialty CareTeam will call you. Our team will welcome you, verify your information to protect your privacy and let you know what services we can provide. We’ll ask how you prefer to receive updates on your prescriptions – by text message, email or both. We will send you a link to get started at CVSspecialty.com.
We’ll review your prescription and insurance information and see if your medication needs a prior authorization. If so, we’ll ask your doctor to submit a request. You’ll also find out how to pay for your medication. If you need help paying for your medication, we can help you find financial assistance from the manufacturer or other patient assistance programs.
If your medication is injected or infused, we can also help you set up any services you or your caregivers may need at home – like self-injection training or infusion assistance. If you need supplies or nursing orders, we’ll request them from your doctor.
Our team will ask some questions about your health. This will help your CVS Specialty pharmacists review your medications to help make sure they don’t interact with your health or your other medications. These questions may include:
The next step is to schedule delivery. Your medication can be sent to your home or work address, your doctor’s office or even a CVS Pharmacy® store*. If your medication has any special storage requirements, the representative will review those with you. They will also review your payment and billing information. If you chose to receive text or email communications, you’ll get a message and tracking number when your package ships.
*Where allowed by law. In-store pick up is currently not available in Oklahoma. Puerto Rico requires first-fill prescriptions to be transmitted directly to the dispensing specialty pharmacy. Products are dispensed by CVS Specialty and certain services are only accessed by calling CVS Specialty directly. Certain specialty medication may not qualify. Services are also available at Long’s Drugs locations.