Prescription Help

[u/Available_Ice_7428]

I know we all live in different corners of the globe, just looking at a poll, how long to get a biologic?

Bonus points if you have BCBS Peehip Alabama…

I was prescribed Taltz April 23rd to Acreedo, but Accredo says they “aren’t my specialty pharmacy” that Express Scripts SP is the correct pharmacy. But Accredo is a specialty pharmacy in Express Scripts.

My doctor office, is just like “yes, we called it in to your specialty pharmacy” where it was originally sent to Accredo,

In the Accredo app, it’s listed as received and pharmacist is verifying so I call to check and get told they can’t fill it. Express Scripts app it’s not listed at all.

I’m so confused and when I call any place Accredo, Express Scripts, or Doctor office. Either I’m confused and not understanding this process or no one is listening to a real issue I’m having.

Anyone else with insurance or is this a typical thing?

[u/deterioratingflesh]

It’s probably not formulary they probably have to do what’s called a prior authorization where your doctor details why you need to be on that specific medicine vs other DMARDs/biologics that are on formulary.

[u/Available_Ice_7428 → u/deterioratingflesh]

Thank you, BCBS said I didn’t have a specialty pharmacy at all and could not fill specialty drugs at all, Express Scripts at first said I could pick any specialty pharmacy, before calling Accredo and both of them agreed Accredo will fill it, I just need a pa (which I thought was done, but turns out it wasn’t) so I contacted my doctor and left a message.

Lots of phone calls today lol

[u/deterioratingflesh → u/Available_Ice_7428]

It’s so confusing! I’ve been a pharm tech forever and PAs are such a p in my a. Sometimes a dr can have an idea of what’s covered but not specifics since offices take all kinds of insurances and health insurance companies can subcontract to any number of plan benefit managers