Medicaid Redesign Team Change Effective April 1, 2013

Date Issued: 4/1/2013

Specialty Pharmacy Choices

As of April 1, 2013, Medicaid managed care and Family Health Plus members may obtain specialty drugs from either our Specialty Pharmacy program or a network retail pharmacy.

EmblemHealth Specialty Pharmacy Program

This program offers a full range of services including:

  • Access to pharmacists
  • Ongoing side effect management
  • Clinical management programs
  • Dedicated pharmacist and nursing support 24 hours a day, seven days a week.

To contact the EmblemHealth Specialty Pharmacy program, call 1-888-447-0295.

Network Retail Pharmacies

Members may choose to bring their specialty drug prescription to any EmblemHealth network pharmacy that has signed an EmblemHealth Specialty Medication Pricing Agreement. This agreement requires the pharmacy to accept a fee comparable to the mail-order specialty pharmacy fee. Before submitting a prescription, members should call their pharmacy to find out if the pharmacy participates in our specialty pharmacy network, or contact EmblemHealth’s Pharmacy Customer Service department at 1-888-447-7364.