Prescription drug prior authorization forms vary depending on the member, the plan and the provider. We require prior authorization for select medications dispensed by pharmacies for most members. For select medications administered in a doctor's office or outpatient facility, we require prior authorization for insured members and for any BlueCross employees and their dependents whom we cover.
If you are administering a medication in your office, find the prior authorization forms you need on the Health Plans page.
If you are prescribing a medication for a patient with Medicare Part D coverage, find the form you need on the Medicare Part D Plans page.
If you are prescribing a medication for a patient with coverage
affected by our Drug Management program, you can find the prior
authorization and step therapy medical necessity exception forms on the Prescription Plans page.