Specialty medications
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How to read your prescription drug formulary
Specialty medications are used to treat complex, chronic health conditions. To see if your medication falls into this category, look for MSP or LDD on the prescription drug formulary in the column labeled “Special Code.”
Specialty medications may be filled for a maximum of 30 days. In 2025, all specialty medications will be filled by the health system pharmacy regardless of who prescribes it. For members of the HSA Advantage plan, coinsurance will be less because of the health system pharmacy’s lower costs.
- Existing prescriptions: No need for you to do anything. The health system specialty pharmacy will work with providers to transition these prescriptions.
- New prescriptions: Ask your provider to send it to the health system’s Southlake Retail Pharmacy location.
Specialty medication costs under the HSA Advantage Plan
For specialty medications, you pay the full cost until you reach your annual deductible. After that, you pay 10% coinsurance with the health system pharmacy.
Specialty medication costs under the Signature Plan
Health system pharmacy In-network pharmacy Cost tier Up to 30 day supply 35-102 day supply Up to 34 day supply 35-102 day supply Tier 1 $ $20.00 Specialty Only covered when filled Tier 2 $$ $100.00 Tier 3 $$$ $200.00 Tier 4 $$$$ N/A
medications may
only be filled for
30 days or less.
by health system pharmacy.