Navigating Specialty Medication Changes: A Guide for Michigan Medicine Patients
Jake Newby
| 4 min read
Jake Newby is a brand journalist for Blue Cross Blue...
Key Takeaways
- Unless a new payment contract is reached between Blue Cross and Michigan Medicine by July 1, 2026, Michigan Medicine patients who rely on specialty medications may have to change the way they fill those prescriptions.
- A specialty pharmacy focuses on dispensing medications used to treat complex, chronic or rare conditions. They also provide a full support system designed to help you manage your treatment.
- Specialty pharmacies handle medications that are typically high in cost and complex to administer, such as injectables or infusions.
- As the exclusive provider within this network, Walgreens Specialty Pharmacy is where members in applicable plans will fill most of their specialty prescriptions.
If you or a loved one rely on specialty medications, you may soon experience an important change in how you fill those prescriptions.
Michigan Medicine has informed Blue Cross it will terminate the in-network status of its southeast Michigan provider network of hospitals, outpatient facilities and physicians on July 1, 2026, unless a new payment contract is signed. Access to medications delivered through the system’s specialty pharmacy is impacted by any termination that occurs.
For many years, Blue Cross Blue Shield of Michigan has worked with Walgreens Specialty Pharmacy to fill prescriptions for specialty medications for our members in Michigan. This includes 39% of Blue Cross members who currently have a Michigan Medicine physician.
Because specialty pharmacy drugs may not be covered if filled by the Michigan Medicine specialty pharmacy after June 30, we are advising our members about their options with Walgreen’s Specialty Pharmacy. Here’s what this may mean for your care and how Blue Cross will support you through the transition if you choose to make it.
What is a specialty pharmacy?
A specialty pharmacy focuses on dispensing medications used to treat complex, chronic or rare conditions. These specialty prescription drugs often require special handling, storage or monitoring, and they may come with higher costs than traditional prescriptions. Conditions that commonly require specialty medications include:
- Cancer
- Multiple sclerosis
- Rheumatoid arthritis
- Certain autoimmune or genetic disorders
How do specialty pharmacies work?
Specialty pharmacies don’t just dispense medication; they provide a full support system designed to help you manage your treatment. Specialty pharmacies strive to make it easier for you to stay on track with your treatment while improving your overall health outcomes. That often includes:
- Coordinating with your doctor to manage prescriptions and refills
- Offering home delivery or convenient pickup options for select medications
- Providing education about how to take your medication
- Monitoring for side effects and helping you manage them
- Giving you 24/7 access to pharmacists and nurses for questions or concerns
What types of drugs do they dispense?
Specialty pharmacies handle medications that are typically high in cost and complex to administer, such as injectables or infusions. These medications may also be sensitive to temperature or handling requirements and prescribed to individuals dealing with ongoing, serious health conditions. These factors make it so that specialty medications often require a higher level of coordination and clinical support than the standard prescriptions your doctor might send to your local pharmacy.
What is Blue Cross’ relationship with Walgreens Specialty Pharmacy?
As the exclusive provider within this network, Walgreens Specialty Pharmacy is where members in applicable plans will fill most of their specialty prescriptions. Through this partnership, members enjoy:
- Access to a wide range of specialty medications
- Cost savings through negotiated drug discounts
- Care coordinators who help manage treatment and connect with other Blue Cross programs
- 24/7 access to pharmacists and nurses
- Additional support programs to help with adherence and side effects
There is no additional fee to participate in the program, which is designed to provide a more seamless, supported experience.
What is the role of a health system like Michigan Medicine in specialty pharmacy?
Health systems like Michigan Medicine often operate their own specialty pharmacies, working closely with care teams to coordinate treatment directly within their system. For some members, that has meant filling specialty prescriptions through Michigan Medicine pharmacies as part of an integrated care experience.
However, beginning July 1, if a new contract is not agreed upon, Michigan Medicine specialty pharmacies will be out of network for members. If you currently are filling a specialty prescription at the Michigan Medicine specialty pharmacy and would like your medication to continue to be covered by BCBSM after June 30, we recommend you consider having that prescription transferred to Walgreens specialty pharmacy.
It’s important to note that not every member or medication is affected. This change does not apply to:
- Specialty medications administered by a health care professional and covered under medical benefits
- Medicare Advantage, Medicare Supplemental (Medigap) or Affinity plans
- Employer groups with custom specialty pharmacy arrangements
Blue Cross will soon begin notifying impacted members by mail with details specific to your plan and instructions on what to do next. Changes like this can feel disruptive, especially when you’re managing a complex condition.
But our goal is to keep your specialty medications affordable while continuing to provide the high level of care and support you need, particularly during unexpected developments like Michigan Medicine’s threatened termination. If you receive a letter, take a few minutes to review it carefully and reach out with any questions. Help is available every step of the way.
For more information about specialty drugs and coverage, go to bcbsm.com/specialtydrug. And learn more about Blue Cross Blue Shield of Michigan's commitment to affordability by visiting bcbsm.mibluedaily.com/affordability.
Photo credit: Getty Images
