Level 4 self-injectables and specialty medications are available through both Lumicera Health Services specialty pharmacy and UW Specialty Pharmacy for non-Medicare members. Members on Medicare have some additional pharmacy options.
Lumicera Health Services specialty pharmacy and UW Specialty Pharmacy may not carry certain specialty drugs or might have depleted the supply of drugs they normally provide. In these cases, a pharmacy that uses other specialty pharmacies can fill members’ prescriptions at no additional cost.
Specialty medications are marked with “ESP” in the formulary. To begin receiving your self-injectable and other specialty medications, please call Navitus SpecialtyRx Customer Care at 1-877-651-4943.
Clear Bagging
Clear bagging is a new program where certain specialty drugs for non-Medicare members will be covered by the pharmacy benefit rather than the medical benefit.
Which Drugs Are a Part of the Program?
Non-cancer specialty medications are dispensed from the UW Specialty Pharmacy for non-Medicare members receiving care in the UW Health System.
How Does This Affect Me?
If you have a medication dispensed under the program, you will receive multiple explanations of benefit (EOB) statements. One from your health plan for the administration of the drug. Another from Navitus, for the drug itself.
This program will not impact your care. You will still have the drugs administered in the same location by the same medical professionals as you would have prior to this program.