July 17, 2026

New Pharmacy Services Program Coming in August
Applies to All Groups, including Fully Insured accounts

• Small Group
• Blue Balance Funded^SM
• Mid-Market
• Custom Fully Insured
• Student Health
• Grandfathered, Transitional and Closed plans

In December, we announced the Pharmacy Match program, which aims to make members’ health care journeys easier for those living with complex, long-term or rare health conditions. 

Pharmacy Match expands the pharmacy network available to Blue Cross and Blue Shield of Illinois members. It also uses a dynamic, real-time referral process to match members with the best-fit pharmacy for filling their specialty and complex care prescriptions within hours.

• Aug. 3, 2026: “New starts” (definition below) to therapy (for any specialty and complex care drug therapeutic categories)
• Sept. 1, 2026: Members currently on specialty and complex care drug therapy for autoimmune and hemophilia conditions
• Oct. 1, 2026: Members currently on specialty and complex care drug therapy for all remaining therapeutic categories

“New starts” are members who are initiating therapy (new authorization and/or prescription) and do not have claim evidence indicating active treatment, or an authorization start date, between June 19, 2026, and Aug. 3, 2026.

For more information: As a reminder, self-funded groups with Prime Therapeutics^® as their Pharmacy Benefit Manager can select Advocate+ Pharmacy Match. Contact your account representative at BCBSIL for more information about either program.

Blue Cross and Blue Shield of Illinois makes no endorsement, representations or warranties regarding third-party vendors and the products and services offered by them. 

Prime Therapeutics, LLC is a separate company Blue Cross and Blue Shield of Illinois contracts with to provide pharmacy solutions. BCBSIL, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics.