Starting Oct. 1, 2026, all fully insured and level-funded groups will be automatically enrolled in the Advocate + Pharmacy Match specialty drug program. This change is designed to help make specialty drug management easier and control costs for everyone.
Program Overview:
Advocate + Pharmacy Match helps members get specialty drugs faster and with less hassle. It connects members with specialty pharmacies and support services, aiming to remove delays and simplify care.
Streamlined specialty drug management
Wide network of pharmacies
Support for members and providers
Clear reporting for plan sponsors
How It Works: Direct Routing and Competitive Bidding
When a specialty drug is prescribed, the system quickly checks with pharmacies to find the best option. If direct routing is possible, it happens almost instantly. For competitive bidding, pharmacies have three hours to submit bids during business hours; if a referral comes in after hours, bidding starts the next business day. The pharmacy with the best offer will provide the medication for the member for a year, including any future specialty drugs.
There is no extra cost for fully insured and level-funded groups—this program is included in your plan. For ASO groups, please reach out to your BCBSNE account team to discuss pricing options.
We are here to support you as we make this change. If you have questions, please contact a member of your account team.
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Hinge Health is an independent company providing musculoskeletal services for Blue Cross and Blue Shield of Nebraska, an independent licensee of the Blue Cross Blue Shield Association.
