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Specialty Medications

Specialty medications are used to treat complex, long-term conditions. These are medications that may need special storage or have side effects that your doctor needs to monitor. Some of these medications are covered by your pharmacy benefits and some are covered by your medical benefits. Prior authorization may be required for most specialty medications. Specialty medications are available through specialty pharmacies, which can provide delivery services to your location of choice or your doctor’s. If you are unable to receive delivery of medication, the specialty medication may be obtained from a retail pharmacy. You may contact Priority Partners to request obtaining a specialty drug from a retail pharmacy.

Find a list of these medications and their authorization requirements on the Priority Partners formulary. Your doctor can request a prior authorization by filling out a prior authorization request and sending it to Priority Partners.

Specialty medications covered under your medical benefit are either given to you by your doctor or taken while your doctor is there with you. Some of these medical drugs may require prior authorization. Your doctor may ask Priority Partners to approve them.

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