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.