New for 2023: Specialty Pharmacies Added In-Network

We’ve expanded our specialty pharmacy network to include Christus Specialty Pharmacy, University Medical Center (UMC) and Red Chip. For our members with Blue Cross and Blue Shield of New Mexico (BCBSNM) pharmacy coverage, these are new dispensing options for specialty medications covered under the pharmacy benefit.

Also new for 2023 is access to the IRX network.

Oral oncology changes:  Effective March 12, 2023, Prime Therapeutics will transition its existing oral oncology network to the IRX network. Pharmacies currently participating in the oral oncology network have been notified of the change and asked to confirm participation in the IRX network. The transition will be seamless for members and there will be no disruption in care.

Finding a specialty pharmacy: An updated list of our in-network specialty pharmacy vendors is on our provider website. Members can view the specialty network list by logging into their Blue Access for Members℠ or MyPrime.com accounts.

Pharmacy details:

  • Christus Specialty Pharmacy
    • Added to the oral oncology network
    • Only ships to Texas and Louisiana
  • UMC
    • Added to the oral oncology network
    • Does not offer shipping or delivery
  • Red Chip
    • Added to the hemophilia network
    • Offers nationwide shipping
  • IRX
    • A clinically integrated program that allows members to receive their oral oncology and other select medications in their health care provider’s clinic or hospital pharmacy
    • The doctor and pharmacist are part of the same team and have direct communication

More information: Call the number on your patient’s member ID card to verify coverage, or for more information on your patient’s benefits.

 

BCBSNM contracts with Prime Therapeutics to provide pharmacy benefit management and related other services. BCBSNM, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics. MyPrime.com is an online resource offered by Prime Therapeutics.

The relationship between BCBSNM and the specialty pharmacies is that of independent contractors.

The information mentioned here is for informational purposes only and is not a substitute for the independent medical judgment of a physician. Members should refer to their certificate of coverage for more details, including benefits, limitations and exclusions. Regardless of benefits, the final decision about any medication is between the member and their health care provider.