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
H.P. ACTHAR GEL® Prior authorization for medical necessity is required when self-administered or physician-administered. B 04/01/12 04/01/16
HAEGARDA Prior authorization for medical necessity is required. Quantity Limits may apply. B 10/15/17
HARVONI® Prior authorization for medical necessity is required. P 10/14/14 01/22/15
HELIXATE FS Prior authorization for medical necessity and dispensing may be required. P 07/01/19
HEMLIBRA Prior authorization for medical necessity and dispensing may be required. P 07/01/19
HEMOFIL M Prior authorization for medical necessity and dispensing may be required. P 07/01/19
HERCEPTIN HYLECTA™ Prior authorization for medical necessity is required. M 08/01/19
HERCEPTIN® Prior authorization for medical necessity is required. M 01/01/15 04/01/16
HETLIOZ® Prior authorization for medical necessity is required. P 10/01/14
HEXALEN Prior authorization for medical necessity is required. P 04/01/18
HIZENTRA™ Prior authorization for medical necessity is required when self-administered or physician-administered. B 04/14/10 04/01/16
HORIZANT® The limits are 60 tablets per 30 days. P 01/01/12 07/01/13
HUMALOG® Humalog may be subject to prior authorization. Patients must have trial and failure of Novolog. P 01/01/15
HUMALOG® KWIKPEN U200 Humalog may be subject to prior authorization. Patients must have trial and failure of Novolog. P 01/01/15
HUMALOG® JUNIOR KWIKPEN Humalog may be subject to prior authorization. Patients must have trial and failure of Novolog. P 01/01/15