June 9, 2021
Pharmacy Members to Have New Home Delivery and Specialty Pharmacy Options Starting Oct. 1
What’s happening: Our pharmacy benefit manager (PBM), Prime Therapeutics® (Prime), signed an agreement to provide its health plan clients, including Blue Cross and Blue Shield of Illinois (BCBSIL), 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 Oct. 1, 2021.
- This will go into effect for our non-HMO employer group, non-HMO retail and Medicaid plans.
- Please note: For our HMO group and retail plans, these pharmacy services are being added to the network as an option for members.
As a reminder, BCBSIL Medicare members will have these pharmacy services added to their network as available options starting Aug. 1, 2021. General information on how to contact the pharmacies will be made available in member communication materials at that time.
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 BCBSIL 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 group and retail members 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 Oct. 1, 2021.
General information on how to contact the pharmacies will be made available in member communication materials. These include the myprime.com 
and bcbsil.com websites and other pharmacy benefit collateral (ex. fliers, letters, handbooks). Members contacting Accredo will be supported by a dedicated onboarding support team to help them register, make sure their patient profiles are complete and get their first fills.
If BCBSIL HMO Illinois® and Blue Advantage HMOSM members would like to use the new pharmacy services on or after Oct. 1, 2021, they will have access to the same general contact information and dedicated onboarding support team at Accredo.
Questions? Look for more information about these new pharmacy services, including member notifications. Join our producer webinar on June 22 or June 24 to learn more about the impact to group business. If you have any questions, contact your BCBSIL representative.
This information applies to members and groups with prescription drug benefits administered through Blue Cross and Blue Shield of Illinois (BCBSIL).
BCBSIL contracts with Prime Therapeutics to provide pharmacy benefit management and related other services. The relationship between BCBSIL and contracting pharmacies is that of independent contractors. BCBSIL, 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 BCBSIL. The relationship between Accredo and BCBSIL 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 BCBSIL. The relationship between Express Scripts® Pharmacy and BCBSIL 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
