Pharmacy Management
- BCBSLA will no longer reimburse providers for certain self-administered medications.
- These self-administered prescription drugs will NOT be covered when obtained from an infusion therapy provider, unless prescribed in conjunction with another drug that must be administered by an intravenous infusion.
- Self-injected medications will continue to be a benefit for our members when purchased at a retail pharmacy, or in some cases, through our specialty pharmacy network.
- Only drugs associated with excluded drug codes are not payable to provider. Physicians may continue to buy and bill all other specialty medications.
- Members with prescriptions for specialty medications should use the BCBSLA specialty network to maximize their insurance benefit.
- View the Drug Authorizations page for information on obtaining authorizations for targeted medications and our Step Therapy program.
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