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Pharmacy Management
Pre-Authorization Resources
Specialty Pharmacy Program
Drug Formulary
Dispensing Limits
Prior Authorization and Step Therapy Programs
e-Prescribing Collaborative Program
Medicare Part D Updates
Over the Counter Equivalent Exclusion Program
Synagis Pre-Authorization Form (PDF)


Step Therapy Medication Listing

The programs listed here may not apply to all prescription drug benefit plans. To determine if any specific benefit plan includes the Step Therapy, and which drug categories listed below are part of the member's plan, please refer to the member's benefit booklet or call the Pharmacy Program number listed on the back of the member's ID card.

The ST Program includes management of the following medications:

Anticonvulsants
Insomia
Antidepressants
Migraine
Cholesterol
Non-sedating Antihistamines
Cox2
Proton Pump Inhibitors
GLP-1 Receptor Agonists
Rheumatoid Arthritis/Psoriasis
Glucose Test Strips
Osteoporosis
Hypertension
 

When a member fills or refills a prescription for one of the medications listed above, the prescription claim will reject and the pharmacy will receive a message stating that prior authorization is required. It is then necessary for the physician to complete and submit a BCBSIL pre-authorization request physician fax form. Continued use of the medication will be available if the patient's medical history and current medical condition warrant it.

If you have questions or concerns regarding these programs, please call (800) 285-9426.

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