Medicare Advantage members need prior authorization for these drugs. If you have prescribed or are prescribing one of these drugs for a Medicare Advantage member, call Caremark's Prior Authorization department at 1-800-294-5979. Caremark is an independent company that provides pharmacy benefits management on behalf of BlueCross.
View the Prior Authorization Criteria drug list.
View the Step Therapy Criteria drug list.
You can also download, print and fax forms for these drugs to Caremark at 1-855-633-7673.
Adcirca Agrylin Ampyra Anabolic Steroids Avonex Boniva Brilinta Buprenorphine Butisol Bydureon Byetta Calcitriol Canitor Celebrex Chantix Copaxone Desferal Duragesic Emend Enbrel Epoetin Alfa ESRD Heparin and Lidocaine Forteo Gilenya Gleevec Hectorol High-Risk Medication Humira Immunosuppressants Injectables B vs. D Letairis Lidoderm Miacalcin Injection Neudexta
Non-Formulary Exception Oral Chemo Pamidronate Provigil Quantity Limits Exception Ranexa Remicade Revatio Revlimid Risperdal Consta Stivarga Symlin Tarceva Tobi Inhalation Zemplar Zytiga