Drug coverage is limited to prescription products approved by the Food and Drug Administration as evidenced by a New Drug Application (NDA), Abbreviated New Drug Application (ANDA), or Biologics Licensed Application (BLA) on file. Any legal requirements or group specific benefits for coverage will supersede this (e.g. preventive drugs per the Affordable Care Act).
Drug coverage may also be subject to policy guidelines established by Blue Cross and Blue Shield of Alabama. Drug coverage policies are not intended to dictate to physicians how to practice medicine. Physicians should exercise their medical judgment in providing the care they feel is most appropriate for their patients.
Please note: Some employer groups may have specific drug coverage requirements for their employees that are not included in the criteria below.
Drug Coverage Guidelines
Search by Drug Name
|Product Name||Guideline||Coverage Benefit*||Implementation Date||Change Date|
|BEBULIN||Prior authorization for medical necessity and dispensing may be required.||P||07/01/19|
|BECONASE AQ®||The limits are 2 bottles per 30 days.||P||11/13/01|
|BELBUCA™||The limit is 2 films per day.||P||10/23/15|
|BELRAPZO™||Prior authorization for medical necessity is required.||M||08/01/19|
|BELSOMRA®||The limits are 1 tablet per day.||P||04/01/15|
|BELVIQ||Prior authorization for medical necessity is required. The limits are 2 tablets per day.||P||07/01/19|
|BELVIQ XR||Prior authorization for medical necessity is required. The limits are 1 tablet per day.||P||07/01/19|
|BENEFIX||Prior authorization for medical necessity and dispensing may be required.||P||07/01/19|
|BENICAR HCT®||Benicar HCT may be subject to step therapy requirements. Patients must have trial and failure of a generic ACE inhibitor or generic ARB.||P||01/01/11||10/01/15|
|BENICAR®||Benicar may be subject to step therapy requirements. Patients must have trial and failure of a generic ACE inhibitor or generic ARB.||P||01/01/11||10/01/15|
|BENLYSTA®||Prior authorization for medical necessity is required.||M||01/01/15||04/01/16|
|BEOVU®||Prior authorization for medical necessity is required.||M||10/07/19||01/01/20|
|BERINERT®||Prior authorization for medical necessity is required when self-administered or physician-administered. Quantity Limits may apply.||B||01/01/15||04/01/16|
|BESPONSA||Prior authorization for medical necessity is required.||M||04/01/18|
|BETASERON®||The limits are 14 vial/syringe units per 28 days and 1 kit (14 prefilled syringes) per 28 days.||P||10/01/12||01/01/14|