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
OBIZUR Prior authorization for medical necessity and dispensing may be required. P 07/01/19
OCALIVA Prior authorization for medical necessity is required. The limits are 1 tablet per day. P 10/01/16
OCREVUS Prior authorization for medical necessity is required. M 03/28/17 06/01/17
OCTAGAM® Prior authorization for medical necessity is required. M 01/01/15 04/01/16
ODEFSEY The limits are 1 tablet per day. P 07/01/16
ODOMZO Prior authorization for medical necessity is required. The limits are 30 capsules per 30 days. P 10/08/15 01/01/16
OFEV® Prior authorization for medical necessity is required. The limits are 2 capsules per day. P 10/20/14
OLEPTRO The limits are 1.5 tablets per day for 150mg and 1 tablet per day for 300 mg strengths. P 10/01/16
OLIMIANT Prior authorization for medical necessity is required. The limites are 1 tablet per day. P 10/01/17 10/01/18
OLYSIO Prior authorization for medical necessity is required. Quantity limits may apply based on strength. P 08/14/15
OMEPRAZOLE The limits are 1 capsule per day. P 01/01/00
OMNARIS® The limits are 1 bottle per 30 days. P 08/06/08 01/01/18
OMNITROPE® Prior authorization for medical necessity is required. P 10/01/11
ONGLYZA® The limits are 1 tablet per day. P 08/27/09
ONPATTRO Prior authorization for medical necessity is required. The limits are 30 mg per 3 weeks. M 08/10/18 07/01/19