A specialty medical benefit drug is typically given as an injection or infusion in the member’s home, physician’s office, freestanding (ambulatory) infusion suite, or outpatient facility. Specialty medical drugs meet certain criteria including, but not limited to:
The drug is used in the treatment of a rare, complex, or chronic disease
A high level of involvement is required by a health care provider to administer the drug
Complex storage and/or shipping requirements are necessary to maintain the drug's stability
The drug requires comprehensive patient monitoring and education by a health care provider regarding safety, side effects, and compliance
For more information on these drugs and conditions or specific Independence benefit information, members can log into ibx.com.
1 Drugs that are not included in this list may either not be considered specialty drugs, or may be available for coverage under the member’s pharmacy benefit. Drugs available under the pharmacy benefit are typically drugs that members can administer to themselves (e.g., oral agents, topical agents, self-injectable drugs). Benefits for pharmacy drugs offered through Independence may vary based on product line, group, or contract. Individual member benefits must be verified. For questions about coverage or specific benefits information, please go to the Independence member portal or call the telephone number on the member’s insurance card.