Blue Links for Employers

New Authorization Requirements for HMO and Blue Choice Plans

Starting July 1, 2015, we will require prior authorization for certain drugs when administered in a doctor's office, by a home health care provider, or in outpatient hospital and dialysis settings. This change does not affect these medications in inpatient, surgical day care, urgent care centers, and ER settings. This change applies to HMO and in-network Blue Choice plans. We encourage members to discuss this change with their health care providers. Members affected by this change will be notified directly no later than June 1, 2015.

For a list of medications that require prior authorization, please visit www.bluecrossma.com/pharmacy and select Pharmacy Management Program and then Prior Authorization.

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