Access Our Comprehensive Formulary
Navigate Patient Medication Options
Explore our detailed formulary to determine the best medication options for your patients, ensuring effective treatments are aligned with their benefits.
View FormularyDISCOVER OUR PREFERRED AND EXCLUSIVE PHARMACY
Beth Israel Lahey Health is Your Preferred Pharmacy Partner
If your patient is a InScript plan member, then BILH pharmacy is our preferred pharmacy. Please note that for specialty prescriptions and any prescriptions greater than a 30-day supply will be required to be filled at BILH pharmacy. Contact BILH pharmacy using the link below.
Contact BILH PharmacyFind Our In-Network Pharmacies
Giving Patients Wider Pharmacy Network Access
Expand options for your patients with access to our broad network of pharmacies, offering your patients flexibility and convenience in filling their prescriptions. Use our pharmacy lookup tool to help your patients find pharmacies near you. If your patient is a InscriptRx plan member, copays may be greater at non-BILH pharmacies.
Search PharmaciesDOWNLOADABLE FORMS AND RESOURCES
Download Provider Forms & Information
-
Plan Resources
Please visit the BILH Benefits Central website to learn more about your prescription benefits.
-
Covered Drugs Requiring Prior Authorization
-
Prior Authorization Forms
A prior authorization (PA) is a clinical program to ensure safety and medical necessity. If you are prescribing a drug that requires a PA, please fill out our general PA form.
As part of the InscriptRx program, weight loss GLP-1s are required to follow certain clinical criteria. If you are prescribing a GLP-1 drug for any indication, please use this form to submit a PA for a product.
-
Specialty Medication Copay Assistance Program
The BILH Copay Assistance Program helps reduce out-of pocket costs incurred by members of our employer-sponsored health insurance plans for certain high-cost medications, called “specialty medications”. Make sure your patients and their covered dependents know they will be contacted if they take a qualifying specialty medication. They can also call 617-589-1162 to confirm if their specialty medication is eligible for financial support through the program.
Access plan design details, blank prior authorization forms, copay programs, and more to streamline your administration tasks.
SUPPORT PATIENT CARE PROGRAMS
Integrate Clinical Programs into Medication Management
-
GLP1 Program
Impacted Medications:
- Bydureon
- Byetta
- Mounjaro
- Ozempic
- Rybelsus
- Saxenda
- Soliqua
- Trulicity
- Victoza
- Wegovy
- Zepbound
Your BILH health plan administered by InscriptRx has adopted unique coverage criteria for glucagon-like peptide-1 (GLP-1) medications. Plan members using GLP-1s for weight loss specifically are required to complete a Medication Therapy Management (MTM) virtual visit with the BILH Weight Loss Management Clinic.
To assist with this process, the BILH Weight Management Team will call to schedule an appointment or they can be reached at 781-352-6551 to answer questions or to proactively schedule your visit.
What to expect during an MTM appointment: A weight loss-specialized pharmacist will assess and evaluate your clinical condition, review any side effects, answer any questions you have about your medications, and discuss lifestyle modifications to enhance your outcomes.
For all indications for GLP-1s, please use this form to submit a prior authorization for the product.
-
Medication Therapy Management (MTM) Program
As part of the InscriptRx clinical program, members on highly complex medications may be required to adhere to InscriptRx’s Medication Therapy Management (MTM) program. The MTM program is a pharmacist led program to optimize therapeutic outcomes, clinical quality, and ensure medical appropriateness. When your prescription requires you to participate in the MTM program, you will be contacted by the InscriptRx Member Services team.
-
Site of Care Management Program
As part of the InScript clinical program, members on highly complex medications may be required to adhere to InScript’s Site of Care Management program. The Site of Care Management program ensures that you are being clinically managed by the appropriate medical provider to ensure the most optimal clinical outcome. If this program is required for prescription coverage, you will need to obtain a second opinion from our network approved provider. When your prescription requires you to participate in the Site of Care Management program, you will be contacted by the InScript Member Services team.
Use our clinical programs designed to enhance your care management. Discover more about GLP1s, Medication Therapy Management (MTM), and Site of Care Management uniquely prepared to support your patients.
FAQs for Providers
You’ve Got Questions, We’ve Got Answers
Find quick answers to your most pressing questions about InScript's Pharmacy Benefit Management.
-
How can I help my patient save on medications?
One of the best ways to help your patient save on prescription costs is to have them fill their medications at BILH pharmacy. With BILH pharmacy being our preferred pharmacy partner, we have negotiated the best prices to allow our members, who are also your patients, to reduce costs and adherence barriers.
-
What should I do if a medication requires prior authorization?
If a medication requires a PA, this means the health plan uses a specific criteria to decide whether the patient meets the guideline for receiving the drug prescribed. As a rule of thumb, please provide as much information as possible for us to appropriately make our determination in a timely manner for your patient. This may include trial and failure of previous therapies, specific lab values and test results, applicable dates, etc.
-
What are real-time benefits checks, how will they help me, and how do I access it?
A real-time benefits check is a feature that allows providers to search if a drug is covered under the patient’s pharmacy benefit and if there are any associated restrictions. This feature can be utilized during the patient visit or during prescribing. Providers can also run a test claim and submit a prior authorization, if applicable, directly from the program. You can utilize this feature if the healthcare system electronic health records are integrated with real-time benefits check.
The biggest advantage of utilizing this feature is to minimize the time between the moment a prescription is given to the patient and the time the patient starts taking the drug.
-
Can I access information on patient eligibility and benefits?
Yes! Click here to see a list of your patient’s covered medications: Formulary. Please note that the formulary is subject to change. Click here to see a summary of your patient’s benefits.
Our dedicated Provider Support Team is available to assist with any questions or needs. Contact the Provider Help Desk at (855) 542-1819 for assistance.
