Specialty Mail Order Covered Prescriptions
If you wish to receive a specialty pharmacy drug from an in-network retail pharmacy rather than through a CVS Caremark Specialty Pharmacy, you may choose any pharmacy in Healthfirst’s retail network as long as that retail pharmacy is willing to accept comparable pricing. If you select a retail pharmacy that has not requested to be in Healthfirst’s Specialty Pharmacy Network, and has not accepted comparable pricing, then the pharmacy should still attempt to adjudicate the claim. If the pharmacist is having any difficulty processing a claim, they should contact the telephone number indicated on the reject message for further processing of the point-of-sale transaction. For a complete list of specialty drugs on Healthfirst’s formulary, please click here.
In-network retail pharmacies interested in applying to the specialty pharmacy network must submit a request by contacting CVS Caremark at SpecialtyPharmacyApplications@cvscaremark.com. Please provide contact information, NPI, the name of the health plan you wish to join for specialty pharmacy networks, and information regarding the member making the request to use your retail pharmacy for accessing specialty pharmacy drugs.