Requesting Medications Not on Your Patient's Approved Medication List (Formulary)įor fastest processing, please submit requests online using CoverMyMeds TM. In-network pharmacy options vary based on the patient's plan benefits.įor Patients with an Essential Medication List (Formulary): If your patient meets the Criteria for Approval of Restricted Products (pdf), and their list says that Prior Review (Prior Authorization) or Step Therapy is required for a medication, but the medication isn't in the Drug Search, please send a request to Blue Cross NC using this General Authorization Fax Form (pdf). Specialty drugs are limited to a 30-day supply and patients must get them from an in-network specialty pharmacy, so their benefits will apply to the prescription.
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