Many of our prescription drug plans include Drug Management programs that promote quality, safety and proper use of certain medications. We base the Drug Management programs on U.S. Food and Drug Administration and manufacturer guidelines, medical literature, safety, accepted medical practice, appropriate use and benefit design.
To request prior authorization or an exception for a medical necessity, please find the appropriate fax form for non-specialty drugs.
For specialty drugs billed under the pharmacy benefit, CVS/specialty will review prior authorization requests. CVS/specialty is a division of CVS Health, an independent company that provides pharmacy benefit management and specialty pharmacy services on behalf of BlueCross. You can make requests by calling 800-237-2767 or faxing 800-323-3445. Beginning June 1, 2016, certain specialty pharmacy drugs billed under the medical benefit will require prior authorization through CVS/caremark's Novologix medical prior authorization system.
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